Correspondence |

Western Blotting as the Confirmatory Test for Syphilis in a Patient With Systemic Lupus Erythematosus

Erika Gaines Levine, MD; Justin J. Green, MD; Warren R. Heymann, MD
Arch Dermatol. 2004;140(4):490-491. doi:10.1001/archderm.140.4.490.
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We describe a patient with systemic lupus erythematosus (SLE) who developed a palmoplantar eruption and positive serologic findings consistent with secondary syphilis. Because of the presence of antiphospholipid antibodies, patients with SLE can have both false-positive nontreponemal and treponemal-specific tests. Western blotting was used to confirm a positive diagnosis of syphilis in our patient. Western blotting is one of the most specific tests in determining whether a patient with SLE has syphilis.1 This case demonstrates the utility of the Western blot with respect to diagnosing syphilis in patients with autoimmune disease.

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Figure 1.

Discrete, grayish-pink, scaly, oval papules scattered over the flexor extremity.

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Figure 2.

A, Histologic picture demonstrating an irregularly acanthotic epidermis with a lichenoid interface dermatitis (hematoxylin-eosin, original magnification ×100). B, Perivascular lymphocytic infiltrate in the dermis with endovascular proliferation (hematoxylin-eosin, original magnification ×400). No eosinophils or plasma cells are evident.

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