Epidemiology of Syphilis, Diagnosis, Differential Diagnosis and Treatment: Up-to-Date Knowledge

Syphilis is an infectious sexually transmitted disease that has re-emerged as a major global public health concern, with a steadily increasing incidence in many regions of the world. It is primarily spread through sexual contact, but can also be transmitted from mother to foetus during pregnancy and, rarely, through blood transfusion. It is estimated that millions of people are affected by syphilis globally, although the exact number of infectious individuals varies by region and is difficult to determine precisely. Despite advances in diagnostic methods and the availability of effective antibiotic treatment, syphilis continues to pose significant diagnostic and epidemiological challenges. Syphilis has been called "the great imitator" because its clinical manifestations can resemble many common dermatologic conditions, such as psoriasis, lichen planus, eczema, pityriasis rosea, and others. In addition to mimicking skin diseases, syphilis can also present with ocular involvement (ocular syphilis) and hepatic manifestations (syphilitic hepatitis), further complicating diagnosis. This review summarises current knowledge on the epidemiology, diagnosis, differential diagnosis, and treatment.