Clinical profile of patients with secondary syphilis at a tertiary care hospital in Tamilnadu- a case series

Abstract

Background: Over the past two years, there has been an alarming rise of syphilis in many of the developed and developing countries, owing to the increase in HIV/AIDS, changes in sex practices, drug abuse and so on. Methods: A total of 10 patients were diagnosed as secondary syphilis in the Venereology Out Patient Department of our hospital over a short period of 4 months from July 2021 to October 2021. Demographic details, presenting complaints, duration of skin lesions, sexual history, treatment history of any other STIs, history of drug abuse, blood transfusion was recorded. Serological tests like VDRL, TPHA, HIV, HBV and HCV were done for all patients. Dark field microscopy and biopsy were done in few cases. Informed and written consent was obtained from all the patients for taking clinical photographs. Results: In our case series we had 6 male patients and 4 female patients. Among six male patients, one was retro positive and he was on antiretroviral therapy. The majority of the patients (6 out of 10) were in the 20-40 years age group. One male patient was a teenager. Eight out of ten patients were married. Two out of 4 female patients were pregnant. Majority of the patients were misdiagnosed earlier as psoriasis, pityriasis rosea, haemorrhoids, perianal wart elsewhere by dermatologists and general practitioners. The commonest morphology of lesions was maculopapular followed by psoriasiform lesions, and pigmentation of palms and soles. Conclusion: Now- a- days, all dermatologists and non-dermatologists should have a heightened awareness of the varied clinical phenotypes of secondary syphilis, its timely recognition and treatment so as to prevent spread to the partners, and also to the community.