Syphilis: uncommon presentations in adults

Area of Science:

• Infectious Diseases
• Dermatology
• Neurology

Background:

• Syphilis, a complex sexually transmitted infection, exhibits a wide spectrum of clinical presentations.
• The disease is historically categorized into primary, secondary, and tertiary stages, each with distinct manifestations.

Purpose of the Study:

• To provide a comprehensive overview of the varied clinical manifestations of syphilis across its stages.
• To highlight uncommon presentations of primary, secondary, and tertiary syphilis in adults.
• To emphasize the importance of early recognition for timely treatment and disease control.

Main Methods:

• Review of historical and clinical descriptions of syphilis manifestations.
• Categorization of symptoms according to the three stages of syphilis.
• Description of atypical presentations within each stage, including primary chancres, secondary syphilids, and tertiary forms.

Main Results:

• Primary syphilis can present with atypical chancres (ulcus durum) varying in size, shape, and location.
• Secondary syphilis (syphilids) encompasses a broad range of cutaneous and mucosal lesions, including macular, papular, papulosquamous, and nodular eruptions, as well as hair and nail changes.
• Tertiary syphilis manifests decades later as gummatous, cardiovascular, or neurosyphilis, with diverse neurological involvements.

Conclusions:

• The clinical variability of syphilis necessitates thorough dermatological and neurological examination.
• Early identification of diverse syphilis symptoms is critical for initiating prompt treatment.
• Prompt treatment and recognition aid in patient recovery and prevent further transmission of syphilis.