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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Immunology

Background:

  • Malignant syphilis is a rare, severe form of secondary syphilis.
  • Historically defined by cutaneous manifestations, its definition needs updating.
  • Syphilis is reemerging, particularly in HIV-positive populations and men who have sex with men (MSM).

Purpose of the Study:

  • To propose a revised definition of malignant syphilis.
  • To expand the definition to include systemic manifestations.
  • To improve recognition and management of this severe syphilis variant.

Main Methods:

  • Literature review and clinical case analysis.
  • Comparison of historical and contemporary syphilis presentations.
  • Analysis of systemic involvement in malignant syphilis.

Main Results:

  • The historical definition solely focused on skin lesions.
  • Increasing syphilis rates in HIV-positive individuals reveal broader systemic involvement.
  • Musculoskeletal, CNS, ocular, ear, cardiovascular, rectal, liver, lung, and renal systems are affected.

Conclusions:

  • The definition of malignant syphilis should encompass systemic manifestations.
  • An updated definition aids in recognizing severe syphilis presentations.
  • Early identification of systemic involvement can prevent long-term complications.