Syphilis: clinical, diagnostic and therapeutic update

Syphilis remains a major global public health concern due to the sustained increase in incidence observed over recent decades, particularly among high-risk populations. Its broad clinical spectrum and ability to mimic numerous dermatological and systemic diseases continue to make it a relevant diagnostic challenge in dermatological practice. This review summarizes the main epidemiological, microbiological, clinical, diagnostic, and therapeutic aspects of Treponema pallidum infection, with special emphasis on mucocutaneous manifestations and recent advances in molecular diagnostic techniques. Current therapeutic strategies, clinical and serological follow-up, and special situations such as neurosyphilis, ocular syphilis, pregnancy, and HIV infection are also reviewed. Finally, emerging preventive challenges are discussed, including doxycycline post-exposure prophylaxis (DoxyPEP), antimicrobial resistance, and future perspectives in vaccine development.