Syphilis Diagnosis and Treatment: State of The Art

Abstract

The present review summarises the current knowledge in the field of syphilis diagnosis and treatment, along with epidemiologic and historical data. A literature search was conducted in PubMed and Google Scholar, using the search terms “syphilis”, “diagnosis”, “dermoscopy”, “management AND treatment”, “laboratory tests AND syphilis”, and “primary OR secondary OR tertiary OR congenital syphilis”. A total of 55 out of 100 papers were included in this review. An overview of the different clinical presentation of primary, secondary, tertiary, and congenital syphilis, with particular attention to dermatologic signs and dermoscopic examination, is provided. The panorama diagnostic procedures are illustrated, along with their accuracy and recommendation. Treatment and management options of patients at different syphilis stages are provided and discussed according to the referring guidelines. The dermatologist can play a key role in providing the early and correct diagnosis and setting up in the proper management of patients with syphilis infection.

Secondary cutaneous and otosyphilis presenting with uncommon skin findings and triggering polycythemia vera

“…3,4 An erythematous rash is usually diffuse all over the body, and well-defined erythematous macules or papules appear on palmoplantar surfaces while oral lesions generally present as mucous patches which can rapidly get ulcerated or covered by gray/white pseudomembranes. 1,2 Here in our case, multiple atypical urticarial-like or dispigmentary lesions were present only on the lower extremities, with an uncommon histological pattern. 1,2 On the other hand, it is known that a suddenonset bilateral tinnitus and uni/bilateral hearing loss can be the first signs of PV because of thrombosis of the feeding labyrinthine artery causing cochlear ischemia.…”

“…It has been hypothesized that photoactivation of melanocytes allows them to leave their stem cell role and seed the epidermis to make pigment, while the JAK inhibitor suppresses the autoimmune CD8+ and IFN-gamma-dependent responses which attack melanocytes and lead to depigmentation. 1 A 66-year-old male (Fitzpatrick skin type VI) was diagnosed with biopsy-proven vitiligo in June 2014. His vitiligo was generalized, covering approximately 70% of BSA, and rapidly pro-…”

“…Oral tofacitinib is a Janus Kinase (JAK) inhibitor that has been observed to be beneficial for patients with vitiligo. 1,2 The hypothesized mechanism is by suppressing the downstream CXCL10 expression, thus giving rise to repigmentation (Fig. 1).…”

Ocular Syphilis: A Case Report

“…Syphilitic uveitis is a rare condition accounting for 1-2% of all uveitis [ 5 ], although the incidence of acquired syphilis is rising in several countries [ 7 ]. Treatment of syphilis depends upon the stage of the disease [ 8 ].…”

Challenges in the Diagnosis of Tertiary Syphilis: Case Report with Literature Review

“…Syphilis is a systemic infectious disease caused by the gram-negative spirochete Treponema pallidum . Humans are its only natural host [ 1 ]. There are an estimated 6 million new syphilis cases each year worldwide in those aged 15–49 years [ 2 ].…”