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Secondary syphilitic lesions.

Robert E Baughn1, Daniel M Musher

  • 1Baylor College of Medicine, Syphilis Research Laboratory, Bldg. 109, Room 234A, VA Medical Center, 2002 Holcombe Blvd., Houston, TX 77030, USA. rbaughn@bcm.tmc.edu

Clinical Microbiology Reviews
|January 18, 2005
PubMed
Summary

Secondary syphilis, caused by Treponema pallidum, has seen decreased incidence and virulence over centuries. Recent US increases are linked to cases among men who have sex with men.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Public Health

Background:

  • Historical accounts note decreased virulence of Treponema pallidum and a drastic reduction in secondary syphilis incidence over three centuries.
  • Early 20th-century syphilologists observed changes in disease manifestations, suggesting an attenuated spirochete form due to rare severe reactions and fatalities.

Purpose of the Study:

  • To review the clinical and diagnostic criteria for recognizing secondary syphilis.
  • To describe the clinical course and manifestations of untreated secondary syphilis.
  • To outline the treatment for secondary syphilis.

Main Methods:

  • Literature review of historical and contemporary data on syphilis.
  • Analysis of trends in syphilis incidence in the United States.
  • Synthesis of clinical and diagnostic information on secondary syphilis.

Main Results:

  • Syphilis incidence in the US increased in 2002, reversing a decade-long decline.
  • This recent rise is largely attributed to increased reported cases among men, particularly homosexual and bisexual men.

Conclusions:

  • Secondary syphilis remains a significant public health concern, despite historical trends of decreased severity.
  • Understanding current trends and clinical presentations is crucial for effective diagnosis and treatment.
  • The review provides a comprehensive overview of secondary syphilis recognition, course, and management.

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