My fourth year of medical school, I was on a dermatology rotation and I had the pleasure of helping care for a female patient with a squamous cell carcinoma of her left index finger.
Syphilis is a sexually transmitted infection characterized by episodes of active disease (primary, secondary and tertiary) with latent periods in between. Syphilis is contagious and transmitted in three ways: (1) intimate contact with an infectious lesion (most common) (2) blood transfusion (3) during delivery of a baby he/she may contract syphilis from the birth canal. This condition is one that dermatologists are able to help manage and, in fact, dermatology has a long history with syphilis. Believe it or not venereal diseases, especially syphilis, played a prominent role in the field's development as distinct from general medicine. This is because often times venereal diseases, such as syphilis, have symptoms that manifest and become visible on the skin – prompting dermatological expertise on the matter! Although the discussion of venereal disease was considered clandestine at the time, the public health risks of syphilis in the late 1800s demanded attention. Dermatologists rose to the task of caring for these underserved patients, and this expertise in syphilis actually helped to establish dermatology as a legitimate medical specialty. In fact, the early medical journals that were published at the time were called the Journal of Dermatology & Syphilology. The name was dropped in the 1950’s due to a decline in the cases of syphilis. Although the number of cases and incidence of early infectious syphilis have fluctuated widely since the 1940s, we currently are in a dire period of syphilis resurgence; the largest number of cases (27,814) and the highest incidence rate of primary and secondary syphilis (8.7 cases per 100,000 population) since 1994 were reported in 2016, which illustrates the inability of public health initiatives to eliminate syphilis due to a plethora of factors. Despite the present day shift into cosmetics, dermatologists still devote vast amounts of time to studying these disease (syphilis, genital warts, genital herpes, etc.). As with our previous blog discussing genital herpes we will devote some time to discussing syphilis because it is still something that we see more often than people think, and Mississippi ranks in the top 15 states with regards to syphilis cases. This means that it is still a very relevant public health issue for the Hattiesburg and Laurel, Mississippi areas.
Primary syphilis begins with a small, round, painless sore (chancre) which usually appears where the bacteria entered the body. This normally occurs about three weeks after infection, but can take up to three months. The chancre remains for about two to six weeks.
Secondary syphilis is mostly characterized by a sore throat and skin rashes on the palms of the hands and soles of the feet. The rashes could however appear anywhere on the body. Other symptoms include:
These symptoms are very often mistaken for other diseases and are the main reason why syphilis is called “the great imitator”. The symptoms will eventually disappear, but you’ll still have the disease.
Latent (hidden) syphilis is the third stage. Symptoms disappear and, although you are still infected, there will be no noticeable signs that you have the disease. Secondary symptoms may reappear, but one can remain “in limbo” for a number of years until tertiary syphilis emerges.
Tertiary syphilis is the final stage of infection and can take up to 30 years to appear. Tertiary syphilis can be life-threatening and can lead to a number of apparently unrelated conditions like:
Quick Facts on Syphilis in Mississippi
Mississippi Centers of Disease Control & Prevention Syphilis Facts:
Syphilis – Primary and secondary (P&S) syphilis (the stages in which syphilis is most infectious) remains a health problem, primarily among men who have sex with men, but congenital transmission of syphilis from infected mothers to their unborn children persists in many areas of the country.
If you find yourself exhibiting symptoms similar to that of syphilis and you want a clear diagnosis come in and see myself or one of my colleagues. The best case scenario is that we rule out the disease, and worst case scenario you have the disease but we can help you manage it. This is a contagious disease and I mentioned above that it has had a resurgence in recent years, which highlights the necessity to be safe and smart when having sex with multiple partners. I stress this because syphilis is a disease that carries serious, if not often fatal, consequences and it is a disease that simply refuses to disappear. We treat a number of skin conditions, cancers, and patients with an immunodeficiency, so who better to reach out to for management of syphilis than a dermatologist? If you’re uncomfortable with coming in the office to be face-to-face with the doctor, you can always utilize our online application to virtually visit one of our providers! The link to the online visits are below.
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