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. 2023 Dec 22;15(1):73-77.
doi: 10.4103/idoj.idoj_187_23. eCollection 2024 Jan-Feb.

Syphilis: Is it Back with a Bang?

Affiliations

Syphilis: Is it Back with a Bang?

Shruti Kamat et al. Indian Dermatol Online J. .

Abstract

Background: Syphilis was brought under control with the advent of penicillin. However, in recent times, a rise in the incidence of syphilis has been reported by Centers for Disease Control and Prevention (CDC).

Aim: To study the clinical and epidemiological profile of patients with syphilis attending sexually transmitted infection (STI) clinic at tertiary care center.

Materials and methods: Observational, cross-sectional analysis of sociodemographic, clinical, and investigational data of all syphilis patients visiting STI clinic from August 2019 to July 2021 was done and analyzed.

Results: Out of 1330 STI patients that attended the clinic, 15.04% (n = 200) were diagnosed with syphilis, among them 72% (n = 144) were males, and 28% (n = 56) were females, with male-to-female ratio of 2.5:1. Of these 24.5% (n = 49) had primary, 44.5% (n = 89) had secondary, 30.5% (n = 61) had latent, and 0.50% (n = 1) had congenital syphilis. Among secondary syphilis patients, rash was the most common presentation seen in 43 patients, followed by condyloma lata in 30, palmoplantar syphilis in 17, oral mucous patch in 3, and iridocyclitis in 3 patients. Human immunodeficiency virus (HIV) was positive in 16.5% (n = 33). Herpes genitalis was the most common coinfection among 25 patients who were diagnosed with mixed venereal disease. RPR titer was positive in all 200 patients, with 1:16 titer being most common.

Conclusion: India is experiencing a new trend in the prevalence of syphilis, mainly due to the changes in risk behavior, misconceptions, and social stigma associated with STIs, improved laboratory diagnosis, and increased public awareness. Particularly secondary and latent stages have shown a rising trend over the past few years. Awareness about safe sexual practices and contraception is very important to control the current resurgence.

Keywords: Human immunodeficiency virus; resurgence; sexually transmitted diseases; syphilis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Primary chancre over coronal sulcus in a male; (b) Primary chancre over labia majora in a female
Figure 2
Figure 2
Various presentations of secondary syphilis (a) Corymbose rash (b) Annular syphilis (c) Lichenoid rash (d) Palmoplantar syphilis (e) Condyloma lata over prepuce (f) Perianal condyloma lata (g) Oral mucous patch
Figure 3
Figure 3
Various presentations in people living with HIV (a) Multiple chancres over prepuce (b) Diffuse nodular syphilis

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