The Syphilis After the Year 2000

Abstract

Syphilis is a systemic disease that initially usually involves the skin and may subsequently spread to almost all internal organs. It has polymorphous manifestations and has been defined by French Dermatologists “la grande mime” because of its ability to mimic many other diseases. If untreated syphilis can be a cause of death many years after infection. Penicillin is still the drug of choice and no documented cases of clinical resistance have been reported. Starting from the year 2000, with the implementation of highly active anti-retroviral therapy (HAART), we observed an important rise in the incidence of syphilis that occurred mostly in men who have sex with men. The increased number of cases brought to light again several clinical pictures, described by dermatologists of the XIX century that was almost forgotten. We can say that Syphilis after the year 2000 has changed in terms of epidemiology, molecular epidemiology, clinical presentation, diagnostic tools, and to a lesser extent therapeutical options. In this chapter, we will go into these issues trying to give an update picture of this old disease.