Cutaneous manifestations of syphilis: Recognition and management

American Journal of Clinical Dermatology

Volumn 7, Issue 5, 2006, Pages 291-304

  Lautenschlager, Stephan ^a  

^a TRIEMLI HOSPITAL   (Switzerland)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIINFECTIVE AGENT; AZITHROMYCIN; BENZATHINE PENICILLIN; CEFTRIAXONE; DOXYCYCLINE; PENICILLIN G; PROBENECID; PROCAINE PENICILLIN; TETRACYCLINE;

DISEASE TRANSMISSION; FOLLOW UP; HERXHEIMER REACTION; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; LYMPHADENOPATHY; ORAL SEXUAL CONTACT; PATHOGENESIS; POLYMERASE CHAIN REACTION; PRIORITY JOURNAL; REVIEW; SEROLOGY; SINGLE DRUG DOSE; SKIN DISEASE; SYPHILIS; TREPONEMA PALLIDUM; ULCER; DIFFERENTIAL DIAGNOSIS; FEMALE; ISOLATION AND PURIFICATION; MALE; PREGNANCY; PREGNANCY COMPLICATION;

ANTI-BACTERIAL AGENTS; DIAGNOSIS, DIFFERENTIAL; FEMALE; HIV INFECTIONS; HUMANS; MALE; PENICILLIN G; PREGNANCY; PREGNANCY COMPLICATIONS, INFECTIOUS; SYPHILIS; SYPHILIS, CUTANEOUS; TREPONEMA PALLIDUM;

EID: 34247228113     PISSN: 11750561     EISSN: None     Source Type: Journal    
DOI: 10.2165/00128071-200607050-00003     Document Type: Review

References (86)

1. Golden MR, Marra CM, Holmes KK. Update on syphilis: resurgence of an old problem. JAMA 2003; 290: 1510-4
2. Hook III EW, Marra CM. Acquired syphilis in adults. N Engl J Med 1992; 326: 1060-9
3. Garnett GP, Aral SO, Hoyle DV, et al. The natural history of syphilis: implications for the transmission dynamics and control of infection. Sex Transm Dis 1997; 24: 185-200
4. Sanchez MR. Syphilis. In: Freedberg IM, Eisen AZ, Wolff K, et al., editors. Fitzpatrick's dermatology in general medicine. New York: McGraw-Hill, 2003: 2163-88
5. van Duynhoven YT. The epidemiology of Neisseria gonorrhoeae in Europe. Microbes Infect 1999; 1: 455-64
6. US Centers for Disease Control and Prevention. Summary of notifiable diseases: United States, 2003. MMWR Morb Mortal Wkly Rep 2005; 52: 1-85
7. Chesson HW, Dee TS, Aral SO. AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s. Sex Transm Dis 2003; 30: 419-24
8. Tichonova L, Borisenko K, Ward H, et al. Epidemics of syphilis in the Russian Federation: trends, origins, and priorities for control. Lancet 1997; 350: 210-3
9. US Centers for Disease Control and Prevention. Outbreak of syphilis among men who have sex with men: Southern California, 2000. MMWR Morb Mortal Wkly Rep 2001; 50: 117-20
10. Nicoll A, Hamers FF. Are trends in HIV, gonorrhoea, and syphilis worsening in western Europe? BMJ 2002; 324: 1324-7
11. Peterman TA, Heffelfinger JD, Swint EB, et al. The changing epidemiology of syphilis. Sex Transm Dis 2005; 32: S4-10
12. Fenton KA, Lowndes CM. Recent trends in the epidemiology of sexually transmit-ted infections in the European Union. Sex Transm Infect 2004; 80: 255-63
13. Tikhonova L, Salakhov E, Southwick K, et al. Congenital syphilis in the Russian Federation: magnitude, determinants, and consequences. Sex Transm Infect 2003; 79: 106-10
14. Musher DM. Early syphilis. In: Holmes KK, Sparling PF, Mardh P, et al., editors. Sexually transmitted diseases. New York: McGraw-Hill, 1999: 479-85
15. DiCarlo RP, Martin DH. The clinical diagnosis of genital ulcer disease in men. Clin Infect Dis 1997; 25: 292-8
16. Lynn WA, Lightman S. Syphilis and HIV: a dangerous combination. Lancet Infect Dis 2004; 4: 456-66
17. Lautenschlager S. Sexually transmitted infections in Switzerland: return of the classics. Dermatology 2005; 210: 134-42
18. Lacey HB, Higgins SP, Graham D. An outbreak of early syphilis: cases from North Manchester General Hospital. Sex Transm Infect 2001; 77: 311-3
19. Dourmishev LA, Dourmishev AL. Syphilis: uncommon presentations in adults. Clin Dermatol 2005; 23: 555-64
20. Hutchinson CM, Hook III EW, Shepherd M, et al. Altered clinical presentation of early syphilis in patients with human immunodeficiency virus infection. Ann Intern Med 1994; 121: 94-100
21. Chapel TA, Prasad P, Chapel J, et al. Extragenital syphilitic chancres. J Am Acad Dermatol 1985; 13: 582-4
22. Schöfer H. Syphilis. Klinik der Treponema-pallidum-Infektion. Hautarzt 2004; 55: 112-9
23. Haustein UF, Pfeil B, Zschiesche A. Analyse der von 1983-1991 an der Universitäts-Hautklinik Leipzig beobachteten Syphilisfälle. Hautarzt 1993; 44: 23-9
24. Alam F, Argiriadou AS, Hodgson TA, et al. Primary syphilis remains a cause of oral ulceration. Br Dent J 2000; 189: 352-4
25. Ashton M, Sopwith W, Clark P, et al. An outbreak no longer: factors contributing to the return of syphilis in Greater Manchester. Sex Transm Infect 2003; 79: 291-3
26. Arunkumar S, Prasad S, Loganathan B, et al. Extragenital chancre of the tongue. Int J STD AIDS 1997; 8: 655-6
27. Hourihan M, Wheeler H, Houghton R, et al. Lessons from the syphilis outbreak in homosexual men in east London. Sex Transm Infect 2004; 80: 509-11
28. Edwards S, Carne C. Oral sex and transmission of non-viral STIs. Sex Transm Infect 1998; 74: 95-100
29. Edwards S, Carne C. Oral sex and the transmission of viral STIs. Sex Transm Infect 1998; 74: 6-10
30. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 1999; 75: 3-17
31. Doherty L, Fenton KA, Jones J, et al. Syphilis: old problem, new strategy. BMJ 2002; 325: 153-6
32. US Centers for Disease Control and Prevention. Transmission of primary and secondary syphilis by oral sex: Chicago, Illinois, 1998-2002. MMWR Morb Mortal Wkly Rep 2004; 53: 966-8
33. Bonci A, Di Lernia V, Lo Scocco G, et al. A patient with primary syphilis of the finger. Acta Derm Venereol 2001; 81: 382-3
34. de Koning GA, Blog FB, Stolz E. A patient with primary syphilis of the hand. Br J Vener Dis 1977; 53: 386-8
35. Weber B. Ein Fall von syphilitischem Primäraffekt am Lid. Klin Monatsbl Augenheilkd 1982; 180: 565-6
36. Donofrio P. Unusual location of syphilitic chancre: case report. Genitourin Med 1986; 62: 59-60
37. Lautenschlager S, Schwarzkopf S, Borelli S. Presternal indurated ulceration: primary syphilis. Dermatology 2006; 212: 200-2
38. Allison SD. Extragenital syphilitic chancres. J Am Acad Dermatol 1986; 14: 1094-5
39. Fournier A. Treatment and prophylaxis of syphilis. London: Rebman Limited, 1906
40. Hutchinson CM, Hook III EW. Syphilis in adults. Med Clin North Am 1990; 74: 1389-416
41. Rompalo AM, Joesoef MR, O'Donnell JA, et al. Clinical manifestations of early syphilis by HIV status and gender: results of the syphilis and HIV study. Sex Transm Dis 2001; 28: 158-65
42. Martin DH, Mroczkowski TF. Dermatologic manifestations of sexually transmitted diseases other than HIV. Infect Dis Clin North Am 1994; 8: 533-82
43. Friedli A, Chavaz P, Harms M. Alopecia syphilitica: report of two cases in Geneva. Dermatology 2001; 202: 376-7
44. Wenhai L, Jianzhong Z, Cao Y. Detection of Treponema pallidum in skin lesions of secondary syphilis and characterization of the inflammatory infiltrate. Dermatology 2004; 208: 94-7
45. Division of STD Prevention, US National Center for HIV, STD, and TB Prevention. Recommendations for public health surveillance of syphilis in the United States [online]. Atlanta (GA): Centers for Disease Control and Prevention, 2003. Available from URL: http://www.cdc.gov/std/SyphSurvReco.pdf [Accessed 2006 Sep 13]
46. World Health Organization. Guidelines for the management of sexually transmitted infections [online]. Geneva: WHO, 2003. Available from URL: http://www.who.int/hiv/pub/sti/en/STIGuidelines2003.pdf [Accessed 2006 Aug 10]
47. Zeltser R, Kurban AK. Syphilis. Clin Dermatol 2004; 22: 461-8
48. Sule RR, Deshpande SG, Dharmadhikari NJ, et al. Late cutaneous syphilis. Cutis 1997; 59: 135-7
49. Löwhagen GB. Syphilis: test procedures and therapeutic strategies. Semin Dermatol 1990; 9: 152-9
50. Cummings MC, Lukehart SA, Marra C, et al. Comparison of methods for the detection of Treponema pallidum in lesions of early syphilis. Sex Transm Dis 1996; 23: 366-9
51. Palmer HM, Higgins SP, Herring AJ, et al. Use of PCR in the diagnosis of early syphilis in the United Kingdom. Sex Transm Infect 2003; 79: 479-83
52. Wheeler HL, Agarwal S, Goh BT. Dark ground microscopy and treponemal serological tests in the diagnosis of early syphilis. Sex Transm Infect 2004; 80: 411-4
53. Rogstad KE, Simms I, Fenton KA, et al. Screening, diagnosis and management of early syphilis in genitourinary medicine clinics in the UK. Int J STD AIDS 2005; 16: 348-52
54. Liu H, Rodes B, Chen CY, et al. New tests for syphilis: rational design of a PCR method for detection of Treponema pallidum in clinical specimens using unique regions of the DNA polymerase I gene. J Clin Microbiol 2001; 39: 1941-6
55. Young H. Syphilis: serology. Dermatol Clin 1998; 16: 691-8
56. Goh BT, Voorst Vader PC. European guideline for the management of syphilis. Int J STD AIDS 2001; 12 Suppl. 3: 14-26
57. Schöfer H, Brockmeyer NH, Hagedorn HJ, et al. Syphilis: Leitlinie der DSTDG zur Diagnostik und Therapie. Hautarzt 2005; 56: 1084-100
58. Rolfs RT, Joesoef MR, Hendershot EF, et al. A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. The Syphilis and HIV Study Group. N Engl J Med 1997 Jul 31; 337 (5): 307-14
59. Young H. Guidelines for serological testing for syphilis. Sex Transm Infect 2000; 76: 403-5
60. US Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR Morb Mortal Wkly Rep 2006; 55 (No. RR-11): 1-100
61. Nandwani R, Evans DT. Are you sure it's syphilis? A review of false positive serology. Int J STD AIDS 1995; 6: 241-8
62. Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev 1995; 8: 1-21
63. Kuznetsov AV, Burgdorf WH, Prinz JC. Latent syphilis confirmed by polymerase chain reaction in 2 HIV-positive patients with inconclusive serologic test results. Arch Dermatol 2005; 141: 1169-70
64. Smith G, Holman RP. The prozone phenomenon with syphilis and HIV-1 coinfection. South Med J 2004; 97: 379-82
65. Taniguchi S, Osato K, Hamada T. The prozone phenomenon in secondary syphilis. Acta Derm Venereol 1995; 75: 153-4
66. Egglestone SI, Turner AJ. Serological diagnosis of syphilis. PHLS Syphilis Serology Working Group. Commun Dis Public Health 2000; 3: 158-62
67. Koff AB, Rosen T. Nonvenereal treponematoses: yaws, endemic syphilis, and pinta. J Am Acad Dermatol 1993; 29: 519-35
68. Marangoni A, Sambri V, Cavrini F, et al. Treponema denticola infection is not a cause of false positive Treponema pallidum serology. New Microbiol 2005; 28: 215-21
69. Erbelding EJ, Vlahov D, Nelson KE, et al. Syphilis serology in human immunodeficiency virus infection: evidence for false-negative fluorescent treponemal testing. J Infect Dis 1997; 176: 1397-400
70. Schmidt BL. Evaluation of a new particle gel immunoassay for determination of antibodies against Treponema pallidum. J Clin Microbiol 2004; 42: 2833-5
71. Schmidt BL, Edjlalipour M, Luger A. Comparative evaluation of nine different enzyme-linked immunosorbent assays for determination of antibodies against Treponema pallidum in patients with primary syphilis. J Clin Microbiol 2000 Mar; 38 (3): 1279-82
72. Schöfer H. Diagnostik und Behandlung der Syphilis: Leitlinien der DSTDG. MedReport 2004; 28: 12
73. Backhouse JL, Nesteroff SI. Treponema pallidum western blot: comparison with the FTA-ABS test as a confirmatory test for syphilis. Diagn Microbiol Inf Dis 2001 Jan; 39 (1): 9-14
74. Goldmeier D, Hay P. A review and update on adult syphilis, with particular reference to its treatment. Int J STD AIDS 1993; 4: 70-82
75. Hicks CB, Benson PM, Lupton GP, et al. Seronegative secondary syphilis in a patient infected with the human immunodeficiency virus (HIV) with Kaposi sarcoma: a diagnostic dilemma. Ann Intern Med 1987; 107: 492-5
76. Augenbraun M, Rolfs R, Johnson R, et al. Treponemal specific tests for the serodiagnosis of syphilis. Syphilis and HIV Study Group. Sex Transm Dis 1998; 25: 549-52
77. Haslett P, Laverty M. The prozone phenomenon in syphilis associated with HIV infection. Arch Intern Med 1994; 154: 1643-4
78. Malone JL, Wallace MR, Hendrick BB, et al. Syphilis and neurosyphilis in a human immunodeficiency virus type-1 seropositive population: evidence for frequent serologic relapse after therapy. Am J Med 1995; 99: 55-63
79. Janier M, Chastang C, Spindler E, et al. A prospective study of the influence of HIV status on the seroreversion of serological tests for syphilis. Dermatology 1999; 198: 362-9
80. Rompalo AM, Cannon RO, Quinn TC, et al. Association of biologic false-positive reactions for syphilis with human immunodeficiency virus infection. J Infect Dis 1992; 165: 1124-6
81. National guideline for the management of early syphilis. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect 1999 Aug; 75 Suppl. 1: S29-33
82. National guideline for the management of late syphilis. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect 1999 Aug; 75 Suppl. 1: S34-7
83. Parkes R, Renton A, Meheus A, et al. Review of current evidence and comparison of guidelines for effective syphilis treatment in Europe. Int J STD AIDS 2004; 15: 73-88
84. Riedner G, Rusizoka M, Todd J, et al. Single-dose azithromycin versus penicillin G benzathine for the treatment of early syphilis. N Engl J Med 2005; 353: 1236-44
85. Lukehart SA, Godornes C, Molini BJ, et al. Macrolide resistance in Treponema pallidum in the United States and Ireland. N Engl J Med 2004; 351: 154-8
86. Mitchell SJ, Engelman J, Kent CK, et al. Azithromycin-resistant syphilis infection: San Francisco (CA), 2000-2004. Clin Infect Dis 2006; 42: 337-45