Correspondence |

A Case of “Syphilis Panniculitis ” Caused by Direct Fat Inoculation by Treponema pallidum

Alisha N. Plotner, MD; Diya F. Mutasim, MD
Arch Dermatol. 2012;148(2):269-270. doi:10.1001/archdermatol.2011.2463.
Text Size: A A A
Published online


Since 2000, there has been a steady increase in the incidence of syphilis in the United States.1 In 2009, 13  997 cases of primary and secondary syphilis were reported, with an incidence rate of 4.6 cases per 100  000 persons.1 In light of this epidemic, the highly treatable nature of the disease, and the potential for serious sequelae if it is left untreated, recognition of the varied cutaneous manifestations of syphilis is critical. A case of secondary syphilis presenting with lesions of panniculitis on the legs is herein described.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. On the left lower leg, several 1- to 3-cm hyperpigmented nodules were found. The nodules were freely mobile over the fascia at the depth of the subcutaneous fat. The arrows indicate 2 nodules.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Histopathologic evaluation. A, Low magnification of the incisional biopsy specimen reveals a lobular subcutaneous infiltrate; epidermis and dermis are unremarkable (hematoxylin-eosin, original magnification ×20). B, The subcutaneous fat reveals a moderate lobular infiltrate of lymphocytes and plasma cells with lobular fat degeneration (hematoxylin-eosin, original magnification ×40). C, Higher magnification reveals numerous lipophages, lymphocytes, and plasma cells surrounding the adipocytes (hematoxylin-eosin, original magnification ×100). D, Immunohistochemical analysis reveals the Treponema pallidum spirochetes (anti – T pallidum antibody, original magnification ×400).




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles