Tree Bark Appearance

A descriptive term referring to intimal and subintimal plaques that encase the mouth of small aortic branches, due to obliterative endarteritis of vasa vasorum with ischemic destruction of the vascular media causing inflammation, neo-vascularisation and fibrous scarring, leading to aneurysms and surface irregularities. While the appearance is typical of tertiary syphilis, it may also be seen in Takayasu’s disease, Reiter’s disease and rheumatic heart disease