A patient with secondary syphilis develops condylomata lata in the perianal region. Histopathology of the lesion reveals which characteristic vascular finding?

• A Leukocytoclastic vasculitis with fibrinoid necrosis
• B Granulomatous angiitis with multinucleate giant cells
• C Lymphocytic vasculitis without plasma cells
• D Endarteritis obliterans with plasma cell-rich perivascular infiltrate ✓

Explanation

All stages of syphilis share a characteristic histopathological vascular finding: endarteritis obliterans (swelling and proliferation of endothelial cells causing luminal narrowing) accompanied by a dense plasma cell-rich perivascular infiltrate. This finding is pathognomonic across primary chancre, secondary lesions (including condylomata lata), and tertiary gummas. In tertiary syphilis, aortitis and neurological involvement are explained by this obliterative endarteritis of vasa vasorum.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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