Conflicts of interest: None.
False-negative anti-treponemal immunohistochemistry in secondary syphilis
Article first published online: 14 MAR 2012
© 2012 The International Society of Dermatology
International Journal of Dermatology
Volume 52, Issue 2, pages 172–176, February 2013
How to Cite
Putri, I., Mercer, S. E., Phelps, R. G. and Levitt, J. O. (2013), False-negative anti-treponemal immunohistochemistry in secondary syphilis. International Journal of Dermatology, 52: 172–176. doi: 10.1111/j.1365-4632.2011.05225.x
- Issue published online: 24 JAN 2013
- Article first published online: 14 MAR 2012
Background While serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, skin biopsies are often performed to control for potential false positives and negatives. Immunohistochemistry using anti-T. pallidum specific antibodies has proven to have a very high sensitivity and specificity for identification of spirochetes in biopsy specimens, but can occasionally fail to identify organisms in clinically and serologically confirmed cases.
Methods We report two cases of apparently negative biopsy specimens in which rare organisms were subsequently identified by detailed study of multiple additional sections.
Results Our experience suggests that the sensitivity of immunohistochemistry for syphilitic spirochetes may be improved by repeat immunostaining.