gumma

A gumma is a localized, inflammatory lesion that can occur in the context of tertiary syphilis. These rubbery, granulomatous masses are typically found in the skin, subcutaneous tissue, bone, or internal organs. They are characterized by a central area of caseous necrosis surrounded by a chronic inflammatory infiltrate, including plasma cells, lymphocytes, and macrophages. Histologically, the hallmark of a gumma is the presence of endarteritis, an inflammation of the small blood vessels. Gummas can vary in size and may appear as nodules or plaques. They are usually painless but can cause symptoms depending on their location and size, such as ulceration of the skin or bone destruction. Diagnosis is typically made through a combination of clinical presentation, serological tests for syphilis, and biopsy of the lesion. Treatment involves penicillin, which is highly effective in resolving gummas and preventing further progression of syphilis. Without treatment, gummas can lead to significant tissue damage and irreversible organ dysfunction.