PDF(Pubmed)
Abstract：
Background: The incidence of syphilis has increased in high-income countries in the past few decades, especially among men who have sex with men. In the present study, we aimed to analyze the correlations between atypical syphilis manifestations and the demographic, clinical, and laboratory features of patients and to review unusual presentations of syphilis reported in the literature. Methods: We conducted a retrospective analysis of 307 patients with syphilis diagnosed between 1 January 2013 and 31 October 2023 at the sexually transmitted infection (STI) centers of the University of Genoa and University of Foggia with both typical and atypical manifestations of disease. Results: In our series, atypical manifestations were detected in 25.8% of the patients, especially in the secondary stage of the disease. Lesions with annular morphology and lesions presenting as itchy erythematous scaly plaques with a psoriasiform appearance were the most common atypical presentations of secondary syphilis. A statistical analysis revealed that homosexual orientation, syphilis reinfection, and venereal disease research laboratory (VDRL) titers > 1:32 were correlated with atypical manifestations. Conclusions: Our study demonstrates that the spectrum of syphilis manifestations, in all the stages of the disease, is wide; atypical manifestations often pose diagnostic challenges, may delay the provision of appropriate treatment, and facilitate the spread of the infection.
摘要：
背景：在过去的几十年中，高收入国家的梅毒发病率有所增加，尤其是与男人发生性关系的男人。在本研究中,我们旨在分析非典型梅毒表现与人口统计学之间的相关性，临床,和患者的实验室特征，并回顾文献中报道的梅毒的异常表现。方法：我们对2013年1月1日至2023年10月31日在热那亚大学和福贾大学性传播感染（STI）中心诊断的307例梅毒患者进行了回顾性分析，这些患者具有典型和非典型疾病表现。结果：在我们的系列中，在25.8%的患者中发现了不典型的表现，尤其是在疾病的第二阶段。具有环状形态的病变和表现为发痒的红斑鳞屑斑块并伴有银屑病样外观的病变是继发性梅毒最常见的非典型表现。一项统计分析表明，同性恋倾向，梅毒再感染,性病研究实验室（VDRL）滴度>1:32与非典型表现相关。结论：我们的研究表明，梅毒的表现谱，在疾病的所有阶段，是广泛的；非典型表现通常会带来诊断挑战，可能会延迟提供适当的治疗，并促进感染的传播。
