Secondary syphilis in persons infected with and not infected with HIV-1: A comparative immunohistologic study

Robert L. McBroom, Angela R. Styles, Michael J. Chiu, Cynthia Clegg, Clay J. Cockerell, Justin D. Radolf

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


To better understand the cutaneous immune response to Treponema pallidum, we performed an immunohistologic study of skin biopsies from a total of 11 patients with secondary syphilis; biopsies from five persons infected with HIV-1 were included in the analysis to assess at the tissue level the impact of concomitant HIV-1 infection on disease expression. In all of the biopsies, staining for HLA-DR, a marker for cellular activation, was observed among infiltrating leukocytes, dermal vascular endothelial cells, and keratinocytes. Infiltrating mononuclear cells stained positively for CD4 or CD8, with CD4+ cells always being in the majority. Surprisingly, most of the CD4+ cells had histiocytic, rather than lymphocytic, morphologic characteristics. Immunostaining for CD 14 confirmed that these cells were monocytic in origin, whereas immunostaining for CD3 revealed that the lymphocytes were predominantly CD8+ cytotoxic T cells. B cells were not detected despite the presence of variable numbers of plasma cells in all specimens. By immunofluorescence, all of the specimens demonstrated perivascular deposition of immunoglobulins, complement, or fibrinogen; linear staining at the dermal-epidermal junction also was observed in most of the specimens. No differences in immunocytochemical or immunofluorescence staining patterns were observed between the specimens from patients who were HIV positive and patients who were HIV negative. In addition to providing a more precise definition of the infiltrating cells in syphilitic lesions, our results, taken as a whole, indicate that cellular immune processes are largely responsible for the development of cutaneous manifestations during syphilitic infection and that coinfection with HIV-1 has little discernible effect on the cutaneous response to T. pallidum.

Original languageEnglish (US)
Pages (from-to)432-441
Number of pages10
JournalAmerican Journal of Dermatopathology
Issue number5
StatePublished - Oct 1 1999


  • HIV-1 infection
  • Immunohistology
  • Secondary syphilis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology


Dive into the research topics of 'Secondary syphilis in persons infected with and not infected with HIV-1: A comparative immunohistologic study'. Together they form a unique fingerprint.

Cite this