Resurgence of syphilis, is it real?: A 6-year retrospective observational study

Syphilis, is a great imitator and presents with a wide range of mucocutaneous and systemic manifestations, which can mimic many diseases. Few studies in India have shown a rise in the prevalence of syphilis which is also shown by Western studies. In view of its latency and myriad presentations, and easy availability of broad-spectrum antibiotics it is being underdiagnosed. This retrospective study aims to evaluate the current trend in the epidemiology of acquired syphilis and other STIs.

Retrospective analysis of all the cases of acquired syphilis registered in INHS Asvini hospital from 2017 to 2022 was done. Complete epidemiological, clinical, and investigational data were recorded and assessed.

Total of 261 cases of STI who presented at our hospital, 28 (10.7%) cases were diagnosed as syphilis. There were 24 (85.7%) males and 4 (14.3%), females. Primary syphilis was diagnosed in 7 (20%), secondary in 10 (35.71%), and latent in 11 (39.28%) cases. Two patients were serologically positive for HIV. Out of the total 261 patients, genital warts was the most common STI diagnosed followed by genital herpes, molluscum contagiosum, urethritis and syphilis.

The epidemiological trend is on the rise for syphilis. The number of cases of primary syphilis diminished significantly, with a concomitant rise in secondary and early latent syphilis. Rise in latent disease points toward either lack of accurate diagnosis or inadequate treatment. Primary stage of the disease is alarming to the patient on account of its site and presents more commonly than the secondary or latent stage. Dermatologists should exercise a high suspicion of syphilis in all asymptomatic eruptions.