Author | Rosa, Mariana Freitas de Assis Pereira | |
Author | Quintella, Leonardo Pereira | |
Author | Ferreira, Luiz Claudio | |
Author | Cuzzi, Tullia | |
Access date | 2023-08-03T00:55:34Z | |
Available date | 2023-08-03T00:55:34Z | |
Document date | 2023 | |
Citation | ROSA, Mariana Freitas de Assis Pereira et al. Immunohistochemical detection of Treponema pallidum in skin samples with clinical and histopathological correlations and Warthin-Starry staining critical analysis. Anais Brasileiros de Dermatologia, v. 98, 4, p. 480-486, Jul./Aug. 2023. | en_US |
ISSN | 0365-0596 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/59886 | |
Sponsorship | The ethics committees of Clementino Fraga Filho University Hospital (HUCFF) of the Federal University of Rio de Janeiro (UFRJ) and Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Brazil, approved the study. The committees waived informed consent because no personally identifiable information was included in the data set used for analysis. | en_US |
Language | eng | en_US |
Publisher | Sociedade Brasileira de Dermatologia | en_US |
Rights | open access | en_US |
Title | Immunohistochemical detection of Treponema pallidum in skin samples with clinical and histopathological correlations and Warthin-Starry staining critical analysis | en_US |
Type | Article | en_US |
DOI | 10.1016/j.abd.2022.02.008 | |
Abstract | Background: Syphilis in its different phases may be a difficult diagnosis in clinical and histopathological grounds. Objectives: The present study objectives were to evaluate the detection and tissue distribution of Treponema pallidum in skin lesions of syphilis. Methods: A blinded diagnostic accuracy study was performed with immunohistochemistry and Warthin-Starry silver staining in skin samples from patients with syphilis and other diseases. Patients attended two tertiary hospitals between 2000 and 2019. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were calculated for the association between immunohistochemistry positivity and clinical-histopathological variables. Results: Thirty-eight patients with syphilis and their 40 biopsy specimens were included in the study. Thirty-six skin samples were used as non-syphilis controls. The Warthin-Starry technique was unable to accurately demonstrate bacteria in all samples. Immunohistochemistry showed spirochetes only in skin samples from patients with syphilis (24/40) with 60% sensitivity (95% CI 44.8‒75.2). Specificity was 100% and accuracy, 78.9% (95% CI 69.8‒88.1). Most cases had spirochetes in both dermis and epidermis and there was a high bacterial load.
Study limitations: Correlation between immunohistochemistry and clinical or histopathological characteristics was observed but was limited statistically due to the small sample size. Conclusions: Spirochetes were promptly seen in an immunohistochemistry protocol, which can contribute to the diagnosis of syphilis in skin biopsy samples. On the other hand, the Warthin-Starry technique showed to be of no practical value. | en_US |
Affilliation | Universidade Federal do Rio de Janeiro. Postgraduate Program in Anatomical Pathology. Faculty of Medicine. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Serviço de Anatomia Patológica. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Serviço de Anatomia Patológica. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Universidade Federal do Rio de Janeiro. Departamento de Patologia. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil. | en_US |
Subject | Diagnosis | en_US |
Subject | Histology | en_US |
Subject | Immunohistochemistry | en_US |
Subject | Syphilis | en_US |
Subject | Treponema pallidum | en_US |
e-ISSN | 1806-4841 | |