Liu XK, et al. - Since secondary syphilis is a sexually transmitted infection, which is referred to as “the great imitator” and has a wide spectrum of clinical manifestations, researchers examined the pathological characteristics of secondary syphilis. Fifty-nine biopsy specimens from 56 patients with secondary syphilis were analyzed. In 39 of 59 secondary specimens, necrotic keratinocytes could be noted. Overall, the most common finding was the plasma cells. At the dermal-epidermal junction, the presence of Treponema pallidum was identified mostly. The authors concluded that one of the features of secondary syphilis is necrotic keratinocytes. Combining plasma cells, irregular acanthosis, elongated rete ridges, and endothelial swelling is expected to boost syphilis probability. No statistical significance was found between pathological characteristics and age, HIV status, or RPR titer.