梅毒疹におけるTreponema pallidumの組織内証明に関する研究

抄録

The author performed skin biopsies on 26 cutaneous lesions from 19 patients with primary or secondary syphilis. The specimens obtained were examined for the existence of Treponema pallidum (T.P.) using silver staining or immunofluorescent complement staining.
The results were as follows:
1) T.P. was observed more frequently under immunofluorescent complement staining than silver staining.
2) Both silver stainingg and immunofluorescent complement staining revealed the presence of numerous T.P. in the epidermis and the dermis in all of the specimens of primary syphilis.
3) In the cases of roseola syphilitica of secondary syphilis, T.P. was not found with silver staining. With immunofluorescent complement staining, however, a small number of T.P. were observed in the perivascular space or in the connective tissue of the superficial dermis.
4) In the cases of syphilis papulosa of secondary syphilis, a small number of Tp. were observed mainly in the lower epidermis in 7 out of 17 cases (41%) with silver staining, while T.P. was observed both in the epidermis and the dermis in 16 out of 18 cases (89%) with immunofluorescent complement staining. In the latter method, the number of T.P. observed in the epidermis was larger than that observed in the dermis in 7 out of 18 cases (39%).
From these results, it seems that the direct observation of T.P. from the lesion using the Indian ink method or the Parker ink method, or the demonstration of T.P. in the tissue with silver staining is highly effective for the diagnosis of syphilis, when the syphilis was in the primary stage.
In contrast, it was rather difficult to demonstrate T.P. in roseola syphilitica of secondary syphilis by the methods of direct observation and silver staining although in syphilis papulosa, those methods were considered to be effective in some cases.