DERMATOLOGICAL AND SYSTEMIC MANIFESTATIONS OF SYPHILIS

The incidence of syphilis is increasing, predominantly among urban het erosexuals. Early recognition is important in preventing progression o f the disease and transmission of Treponema pallidum to the fetus. Unt reated primary syphilis is characterized by intervals of active diseas e punctuated by periods of latency. Not all patients progress through each phase, and the physician must be alert to varying presentations. Cutaneous lesions are the hallmark of syphilis. However, diagnosis can be difficult, because the lesions can be asymptomatic or transient. T he course of syphilis is accelerated in patients infected with the hum an immunodeficiency virus, and these patients frequently exhibit atypi cal lesions. The incidence of congenital syphilis is increasing, and e fforts to control fetal morbidity depend on prompt recognition and tre atment of infection during pregnancy. The definitive diagnosis of any stage of syphilis is based on historical and clinical findings support ed by serologic testing.