[Translated article] AEDV Expert Consensus for the Management of Syphilis

Area of Science:

• Infectious Diseases
• Public Health
• Dermatology

Background:

• Syphilis is re-emerging globally, particularly in Western countries, despite available treatments.
• Spain reported 6613 new syphilis cases in 2021, with a significant increase since 2000, predominantly affecting men.
• The disease presents with diverse clinical manifestations, often mimicking other conditions.

Purpose of the Study:

• To review the current epidemiology, clinical presentation, diagnostic methods, and treatment of syphilis.
• To emphasize the importance of timely diagnosis and appropriate management in the context of re-emergence.
• To highlight screening recommendations for high-risk populations and pregnant women.

Main Methods:

• Review of recent syphilis case data from Spain (2021 incidence).
• Discussion of diagnostic advancements, including molecular assays (PCR) and automated serological tests (EIA, CLIA).
• Overview of recommended follow-up protocols and treatment guidelines.

Main Results:

• Syphilis incidence in Spain was 13.9 per 100,000 inhabitants in 2021, with 90.5% of cases in men.
• Clinical presentations are highly variable, ranging from typical lesions to less common manifestations.
• Penicillin remains the primary treatment of choice for all syphilis stages and populations.

Conclusions:

• Syphilis re-emergence necessitates heightened awareness and robust public health strategies.
• Accurate diagnosis relies on integrating clinical, epidemiological, and laboratory findings.
• Effective management includes prompt treatment, contact tracing, and regular follow-up, especially for vulnerable groups.