Main Article Content
Abstract
Highlights:
- The importance of having a strong suspicion for syphilis and maintaining close contact between dermatologists and pathologists cannot be understated.
- Understanding the clinical relationship and histopathological features of syphilis is crucial for accurate diagnosis and distinction from its histopathologic mimickers.
Abstract:
Syphilis, also known as "the great imitator," is a sexually transmitted infection with a variety of clinical symptoms and histopathological similarities to other infectious diseases. Public health concerns about syphilis have grown significantly. Since 2000, there has been an increase in syphilis prevalence in the United States, with a 17.6% increase from 2015 to 2016. From 2000 to 2019, the number of syphilis cases throughout Asia increased from 0.9% to 30.9%, whilst the number of cases in Indonesia decreased from 22.5% to 14.4%. Specific serological tests for syphilis can usually detect and confirm the diagnosis and offer follow-up care in most cases. However, in certain instances, the clinical characteristics discovered during testing can be identical to those of other diseases, which may lead to inconsistent diagnosis. Considering that the diagnostic pathology is pertinent to the clinical circumstances, a histopathological investigation may be useful for differentiating syphilis mimickers. Pathology is essential for identifying potential syphilis patients with ambiguous clinical symptoms. This study's purpose was to assist dermatologists and pathologists in identifying "mimickers" that require a biopsy and in determining the correct diagnosis and treatment coutsed based on etiology.
Keywords
Article Details
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References
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- Çakmak SK, Tamer E, Karadağ AS, et al (2019). Syphilis: A great imitator. Clinics in Dermatology 37, 182–91. doi: 10.1016/j.clindermatol.2019.01.007.
- Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta.
- Chandrasekar PH (2017). Syphilis. Medscape.
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- Daili SF, Indriatmi W, Zubier F, et al (2015). Infeksi menular seksual: Pedoman praktis diagnosis & tatalaksana. Kementerian Kesehatan Republik Indonesia, Jakarta.
- Elder DE (2017). Lever's Histopathology of the Skin, 11th edn. Lippincott Williams & Wilkins.
- Elston D, Ferringer T, Ko C, et al (2014). Dermatopathology.
- Flamm A, Parikh K, Xie Q, et al (2015). Histologic features of secondary syphilis: A multicenter retrospective review. Journal of the American Academy of Dermatology 73, 1025–30. doi: 10.1016/j.jaad.2015.08.062.
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- Groh J, Patino WD (2014). Increased frequency of histologic diagnosis of syphilis in older individuals during the last five years. Journal of the American Osteopathic College of Dermatology 30, 44–7.
- Gunn RA, Klausner JD (2019). Enhancing the control of syphilis among men who have sex with men by focusing on acute infectious primary syphilis and core transmission groups. Sexually Transmitted Diseases 46, 629–36. doi: 10.1097/olq.0000000000001039.
- Habibie DP, Murtiastutik D, Rahmadewi R (2019). Polymerase chain reaction chlamydia trachomatis examination in nonspecific genital infection patients. Dermatology Reports. doi: 10.4081/dr.2019.8055.
- Ho EL, Lukehart SA (2011). Syphilis: Using modern approaches to understand an old disease. Journal of Clinical Investigation 121, 4584–92. doi: 10.1172/JCI57173.
- Holmes KK, Sparling PF, Stamm WE, et al (2008). Sexually transmitted disease. McGraw-Hill, New York. [Web Page]
- Hook EW (2017). Syphilis. Lancet 389, 1550–7. doi: 10.1016/S0140-6736(16)32411-4.
- Irizarry L, Velasquez J, Wray AA (2021). Chancroid. StatPearls.
- Johnston R (2012). Spirochetal infections. In Weedon's skin pathology essentials, pp. 435–9. Elsevier.
- Klausner JD (2019). The great imitator revealed: Syphilis. Topics in Antiviral Medicine 27, 71–4.
- Ko CJ, Barr RJ (2017). Dermatopathology: Diagnosis by first impression, 3rd edn. John Wiley & Sons.
- Kojima N, Klausner JD (2018). An update on the global epidemiology of syphilis. Current Epidemiology Reports 5, 24–38. doi: 10.1007/s40471-018-0138-z.
- Liu XK, Li J (2020). Histologic features of secondary syphilis. Dermatology 236, 145–50. doi: 10.1159/000502641.
- Purnamasari I, Barakbah J, Martodiharjo S, et al (2021). Secondary syphilis during pregnancy: The importance of screening and clinical management. Berkala Ilmu Kesehatan Kulit dan Kelamin 33, 145. doi: 10.20473/bikk.V33.2.2021.145-149.
- Tuddenham SA, Zenilman JM (2019). Syphilis. In Fitzpatrick's Dermatology, ed. Kang S, Amagai M, Bruckner A, Enk A, Margolis D, McMichael A & Orringer J. McGraw Hill.
- Wardiana M, Prakoeswa CRS, Sawitri S, et al (2022). Dealing with tests and treatments for HIV, syphilis, and hepatitis B infection to prevent mother-to-child transmission (MTCT) from a tertiary hospital in Indonesia. Bali Medical Journal 11, 334–40. doi: 10.15562/bmj.v11i1.3376.
- World Health Organization (2011). Prevalence and incidence of selected sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and trichomonas vaginalis: Methods and results used by WHO to generate 2005 estimates.
- World Health Organization (2017). Kajian nasional respon HIV di bidang kesehatan Republik Indonesia. [Web Page]
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- Zhu S, Viejo-Borbolla A (2021). Pathogenesis and virulence of herpes simplex virus. Virulence 12, 2670–702. doi: 10.1080/21505594.2021.1982373.
References
Ali R, Perez-Downes J, Baidoun F, et al (2016). Challenges in treating secondary syphilis osteitis in an immunocompromised patient with a penicillin allergy: Case report and review of the literature. Case Reports in Infectious Diseases 2016, 1–6. doi: 10.1155/2016/4983504.
Çakmak SK, Tamer E, Karadağ AS, et al (2019). Syphilis: A great imitator. Clinics in Dermatology 37, 182–91. doi: 10.1016/j.clindermatol.2019.01.007.
Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta.
Chandrasekar PH (2017). Syphilis. Medscape.
Daili SF, Indriatmi W, Wiweko SN, et al (2013). Pedoman tata laksana sifilis untuk pengendalian sifilis di layanan kesehatan dasar.
Daili SF, Indriatmi W, Zubier F, et al (2015). Infeksi menular seksual: Pedoman praktis diagnosis & tatalaksana. Kementerian Kesehatan Republik Indonesia, Jakarta.
Elder DE (2017). Lever's Histopathology of the Skin, 11th edn. Lippincott Williams & Wilkins.
Elston D, Ferringer T, Ko C, et al (2014). Dermatopathology.
Flamm A, Parikh K, Xie Q, et al (2015). Histologic features of secondary syphilis: A multicenter retrospective review. Journal of the American Academy of Dermatology 73, 1025–30. doi: 10.1016/j.jaad.2015.08.062.
Ghaznawie M (2013). Peran dermatopatologi pada diagnosis berbagai kelainan kulit.
Groh J, Patino WD (2014). Increased frequency of histologic diagnosis of syphilis in older individuals during the last five years. Journal of the American Osteopathic College of Dermatology 30, 44–7.
Gunn RA, Klausner JD (2019). Enhancing the control of syphilis among men who have sex with men by focusing on acute infectious primary syphilis and core transmission groups. Sexually Transmitted Diseases 46, 629–36. doi: 10.1097/olq.0000000000001039.
Habibie DP, Murtiastutik D, Rahmadewi R (2019). Polymerase chain reaction chlamydia trachomatis examination in nonspecific genital infection patients. Dermatology Reports. doi: 10.4081/dr.2019.8055.
Ho EL, Lukehart SA (2011). Syphilis: Using modern approaches to understand an old disease. Journal of Clinical Investigation 121, 4584–92. doi: 10.1172/JCI57173.
Holmes KK, Sparling PF, Stamm WE, et al (2008). Sexually transmitted disease. McGraw-Hill, New York. [Web Page]
Hook EW (2017). Syphilis. Lancet 389, 1550–7. doi: 10.1016/S0140-6736(16)32411-4.
Irizarry L, Velasquez J, Wray AA (2021). Chancroid. StatPearls.
Johnston R (2012). Spirochetal infections. In Weedon's skin pathology essentials, pp. 435–9. Elsevier.
Klausner JD (2019). The great imitator revealed: Syphilis. Topics in Antiviral Medicine 27, 71–4.
Ko CJ, Barr RJ (2017). Dermatopathology: Diagnosis by first impression, 3rd edn. John Wiley & Sons.
Kojima N, Klausner JD (2018). An update on the global epidemiology of syphilis. Current Epidemiology Reports 5, 24–38. doi: 10.1007/s40471-018-0138-z.
Liu XK, Li J (2020). Histologic features of secondary syphilis. Dermatology 236, 145–50. doi: 10.1159/000502641.
Purnamasari I, Barakbah J, Martodiharjo S, et al (2021). Secondary syphilis during pregnancy: The importance of screening and clinical management. Berkala Ilmu Kesehatan Kulit dan Kelamin 33, 145. doi: 10.20473/bikk.V33.2.2021.145-149.
Tuddenham SA, Zenilman JM (2019). Syphilis. In Fitzpatrick's Dermatology, ed. Kang S, Amagai M, Bruckner A, Enk A, Margolis D, McMichael A & Orringer J. McGraw Hill.
Wardiana M, Prakoeswa CRS, Sawitri S, et al (2022). Dealing with tests and treatments for HIV, syphilis, and hepatitis B infection to prevent mother-to-child transmission (MTCT) from a tertiary hospital in Indonesia. Bali Medical Journal 11, 334–40. doi: 10.15562/bmj.v11i1.3376.
World Health Organization (2011). Prevalence and incidence of selected sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and trichomonas vaginalis: Methods and results used by WHO to generate 2005 estimates.
World Health Organization (2017). Kajian nasional respon HIV di bidang kesehatan Republik Indonesia. [Web Page]
Yuindartanto A, Hidayati AN, Indramaya DM, et al (2022). Risk factors of syphilis and HIV/AIDS coinfection. Berkala Ilmu Kesehatan Kulit dan Kelamin 34, 114–9. doi: 10.20473/bikk.V34.2.2022.114-119.
Zhu S, Viejo-Borbolla A (2021). Pathogenesis and virulence of herpes simplex virus. Virulence 12, 2670–702. doi: 10.1080/21505594.2021.1982373.