No abstract available.
Serologic Tests* ; Syphilis, Latent*

BACKGROUND: There are many differences in the prevalence of syphilis according to the objects and districts. Recently, the incidence of syphilis increased in the world because of various factors. OBJECTIVE: The purpose of this study is to investigate the changes of the epidemiological, clinical characteristics, and stages of syphilis. METHODS: We selected 357 patients with reactive results on VDRL among 79,991 cases who visited in our hospital, between January 2002 and December 2007. We assessed the age, gender, skin lesion, serologic result, clinical stage, treatment history, and underlying disease. RESULTS: During the 7-year period under study, the reactive rate of serum VDRL test was 4.5% in 79,991 people (preoperation or admission examinees: 35.0%. physical examinees: 30.8%, skin lesion: 21.3%, partner's (+): 9.0%, pregnant women: 3.7%). The annual incidence of syphilis had increased from 3.5% in 2002 to 6.3% in 2007. On a total 357 sera with reactive results on VDRL, the symptomatic syphilis rate was 21.3%, increased from 13.6% in 2002 to 26.8% in 2007 (p=0.001). Statistically, there are differences in age distribution between both sexes. The male:female ratio was 1:3.3 in 0~19 years and 1.9:1 in 60~69 years (p=0.029). The incidence of symptomatic syphilis cases was 8 (66.7%) in 0~19 years, 22 (39.3%) in 20~29 years, while latent syphilis was 53 (74.6%) in 50~59 years and 35 (60.3%) in 60~69 years (p<0.001). CONCLUSION: This study suggests that the incidence of symptomatic syphilis may be increasing. Further observation, analysis, and continued vigilance in the general population are required.
Age Distribution ; Humans ; Incidence ; Prevalence ; Skin ; Syphilis ; Syphilis, Latent

On the basis of stastistical awlysis trend of increase in syphilis patients in Korea closely resembles that reported in other countries. Among these patients, it should be noticed that thy were highly infectious, showing early latent syphilis. Nevertheless, the available diagnstic test for syphilis has only been limited to the Non-treponemal antigen test. Moreover not only schedules employing in the treatment f disease have been different among physicians but the follow up test for each patient bas been quite impossible. In these respects, the author strongly suggests that the effective measures for the prevention and treatment of syphilis will be required as a national policy.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Korea* ; Syphilis* ; Syphilis, Latent

The recent prevalence of syphilis has known to be increased progressively throughout the world, since middle of 1950. In Korea, current trend of increased syphilic infection has became a major public health problem. The authors selected sero-positive patients, among the outpaients of department of dermatology, urology, OB & GY, and physical examination, and performed statistical analysis of this sero-positive patients. Results are as following; 1) Of the 2,007 patients taken physical examination, 30 patient(1.49%) were reactive to VDRL. 2) 0.71% of the total out patients of the dermatologic dcpartment were sero-positive. Annual ratio of the syphilitic patient were increased progressively. 3) Ratio of the syphilitic patients to the total outpatients of OB & GY department was 0.55% and somewhat increased since 1976. 4) In the age distribution, the third decade shared 51.8% of the total sero-positive patients 5) In the sexual ratio. male:female=l: l. 62 in the total sero-positive patients. (male:female=l: 1.06 in the dermatologic department.) 6) In the stage distribution, latent syphilis patients were 59.14% of the total syphilitic patients.
Age Distribution ; Dermatology ; Female ; Humans ; Korea ; Outpatients ; Physical Examination ; Prevalence ; Public Health ; Syphilis ; Syphilis, Latent ; Urology

BACKGROUND: The infection rate of syphilis in married couples has been reported by a few investigators during the 1940s. However, studies on recent trends of that particular aspect of syphilis in married couples have not yet been done. OBJECTIVE: We therefore studied the infectivity of T. pallidum and recent trends of conjugal syphilis by observing the spouses of patients with untreated syphilis. METHODS: Couples married for more than 1 year who visited Yonsei Medical Center from 1983 to 1990 for syphilis were entered into this study. We observed the infection rate among spouses of 224 index patients (defined as, between husband and wife, the one who was the first to be diagnosed to have syphilis) who were not treated for syphilis. Syphilis was diagnosed on the basis of physical examination, history of extramarital sexual contacts, and the results of VDRL, TPHA, FTA-ABS, and 19S(IgM)-FTA tests. RESULTS: Fifty-six wives(48%) of 117 male index patients and 50 husbands (47%) of 107 female index patients had been infected at the time of examination. Among the 224 couples, 106(47%) were both infected and in 118(53%), only either husbands(27%) or wives(26%) were infected. Two spouses(50%) of the 4 first incident patients with primary syphilis, 9(53%) of 17 with secondary syphilis and 23(72%) of 32 with early latent syphilis were infected at the time of examination. CONCLUSION: From our results showing the low infection rates among married couples, even in early syphilis when the infectivity is high, it can be deduced that T. pallidum has only a low infectivity.
Family Characteristics ; Female ; Globus Pallidus ; Humans ; Male ; Physical Examination ; Research Personnel ; Spouses ; Syphilis* ; Syphilis, Latent

BACKGROUND: Recently, there has been an increase in the prevalence of syphilis in Korea and in case reports of treatment failures of syphilis. OBJECTIVE: This study was designed to explicate the clinical and laboratory features of syphilis, underlying diseases of the VDRL false-positive group, and responses to treatment of patients with syphilis. METHODS: Between January 2001 and June 2010, we selected 115 patients with reactive results on the VDRL test. We evaluated several characteristics including their age, gender, clinical stage, skin lesion, serologic result, the rate and the underlying diseases of the VDRL false-positive group, and their serologic responses to syphilis treatment. RESULTS: There was no significant difference in the incidence of syphilis by gender except in the case of primary syphilis. The annual incidence of syphilis has shown a significant upward trend, especially in the younger age group (10~39 years). Using a serum VDRL titer of 8 as a cut-off value, we found a significant difference between early and latent syphilis. The rate for the VDRL false-positive group was 24.3%. Treatment failures were not reported and the median time to a successful serological response for patients with early syphilis treated with penicillin was 106 days. The Jarish-Herxheimer reaction occurred in 13.7%, and these symptoms were self-limited without any treatment. CONCLUSION: The annual incidence of syphilis in Korea has shown a significantly upward trend, especially in the younger age group. All responses evaluated were reported for those treated successfully without having any significant adverse effects. Thus, continued surveillance and adequate treatment of syphilis is important not only to enhance disease control but also to improve public health.
Humans ; Incidence ; Korea ; Penicillins ; Prevalence ; Public Health ; Skin ; Syphilis ; Syphilis, Latent ; Treatment Failure

BACKGROUND: Syphilis is infectious and chronic disease transmitted sexually and caused by Treponema pallidum subspecies pallidum. Thanks to the wide-ranging variance in clinical presentations, the disease has earned the name, "the Great Mimicker". The prevalence rate of syphilis in Korea dropped sharply since the 1970s and has remained low until recently when the rate started to show signs of a modest but clear increase. OBJECTIVE: The objective of this study is to evaluate the incidence of syphilis and describe its clinical characteristics of each stage as we have observed for the past 8 years at our hospital. METHODS: We conducted a retrospective analysis on the 279 syphilis patients who visited our hospital from 2000 to 2007. For the diagnosis of the disease, we used nontreponemal (VDRL) and treponemal test (TPHA, FTA-ABS) in serum and evaluated the clinical features of the subjects. RESULTS: The annual incidence and prevalence rate of early syphilis showed a statistically significant upward trend. By gender, the annual incidence rate among males also drew an upward curve. Among 279 patients, 28 cases of early syphilis were found in males, whereas only 16 cases were found in females. Early syphilis is found most frequently in the twenties. Secondary syphilis showed various skin lesions including alopecia syphlitica, macular syphilid, papulosquamous syphlid and annular patch. Nine cases among 19 syphilis patients showed coppery red macules on palms and soles. One case of early latent syphilis was found in a HIV-positive patient. The serum VDRL titers according to stages did not show a statistically significant difference. CONCLUSION: We have observed statistically significant (p<0.05) increase in the incidence and prevalence rates of early syphilis in recent years. Thus, dermatologists should be rightly aware of and familiarize themselves with the diverse clinical features of syphilis and be attentive and alert to effectively diagnose the disease in its early stages.
Alopecia ; Chronic Disease ; Female ; Humans ; Incidence ; Korea ; Male ; Prevalence ; Retrospective Studies ; Skin ; Syphilis ; Syphilis, Cutaneous ; Syphilis, Latent ; Treponema pallidum

BACKGROUND: Syphilis is infectious and chronic disease transmitted sexually and caused by Treponema pallidum subspecies pallidum. Thanks to the wide-ranging variance in clinical presentations, the disease has earned the name, "the Great Mimicker". The prevalence rate of syphilis in Korea dropped sharply since the 1970s and has remained low until recently when the rate started to show signs of a modest but clear increase. OBJECTIVE: The objective of this study is to evaluate the incidence of syphilis and describe its clinical characteristics of each stage as we have observed for the past 8 years at our hospital. METHODS: We conducted a retrospective analysis on the 279 syphilis patients who visited our hospital from 2000 to 2007. For the diagnosis of the disease, we used nontreponemal (VDRL) and treponemal test (TPHA, FTA-ABS) in serum and evaluated the clinical features of the subjects. RESULTS: The annual incidence and prevalence rate of early syphilis showed a statistically significant upward trend. By gender, the annual incidence rate among males also drew an upward curve. Among 279 patients, 28 cases of early syphilis were found in males, whereas only 16 cases were found in females. Early syphilis is found most frequently in the twenties. Secondary syphilis showed various skin lesions including alopecia syphlitica, macular syphilid, papulosquamous syphlid and annular patch. Nine cases among 19 syphilis patients showed coppery red macules on palms and soles. One case of early latent syphilis was found in a HIV-positive patient. The serum VDRL titers according to stages did not show a statistically significant difference. CONCLUSION: We have observed statistically significant (p<0.05) increase in the incidence and prevalence rates of early syphilis in recent years. Thus, dermatologists should be rightly aware of and familiarize themselves with the diverse clinical features of syphilis and be attentive and alert to effectively diagnose the disease in its early stages.
Alopecia ; Chronic Disease ; Female ; Humans ; Incidence ; Korea ; Male ; Prevalence ; Retrospective Studies ; Skin ; Syphilis ; Syphilis, Cutaneous ; Syphilis, Latent ; Treponema pallidum

A clinical survey on the syphilitic cases of the military personnel was carried out during the period of 18 months from July, l976 to December, 1977 by means of ready-made STD chart and questianaire. This survey included 180 cases of syphilitic patients who had been diagnosed and treated in the Dept. of Dermatology of ROK Army Hospital. The results can be summarized as follows: I . Total 180 cases af syphilis were classified as 147 cases (81.7%) of secondary syphilis, 22 cases (12. 2%) of primary syphilis and 11 cases (6. l%) of latent syphilis. The cases of secondary syphilis were camposed of 96 cases (65. 3%) of alopecia syphilitica, 88 cases (60.0%) of condyloma latum, 12 cases (8. 2%) of macular syphilid and 1 case (0. 7%) of mucous patch, each. 3. Among 147 cases of secondary syphilis, 42 cases (28.6%) had a positive history of typical chancre at the genital region. III. 68. 3% of patients had first sexual experience between the age of 18 and 20 and the average age was 19.1 years. 71.7% of total patients of syphilis were between the age of 21 and 23 and the average age was 22.8 years. IV. Fourteen cases(63.6%) of primary syphilis had the chancre on the coronal sulcus, 4 cases(18.2%) on the prepuce, 3 cases(13.6%) on the penile shaft and 1 case(4.5%) on the glans penis. V. To review the number of the lesion of 88 cases of condyloma latum, 45 cases(51.1%) had one to three lesions and the average number of the lesion was 3.7 Predilection sites of condyloma latum were perianal region(90.9%), penile shaft(11.4%), scrotum(6.8%) and corona and coronal sulcus(4.5%). VI. Out of 180 cases, 76 cases(42.2%) had a past history of other STD, and 26 cases(14.4%) had other coincidently combined STD which were composed of condyloma acuminatum(8.9%) urethritis(3.3%), chancroid(1.6%) and pediculosis pubis(0.6%). VII. The most common partners of the first sexual experience was lover(50.0%) and followed by barmaid(25.6%) and prostitute(8.9%). Barmaid(56.7%) was the most frequently suspected source of present infection and other sources were prostitute(18.9%) and lover(.9.4%).
Alopecia ; Chancre ; Dermatology ; Hospitals, Military ; Humans ; Lice Infestations ; Male ; Military Personnel ; Penis ; Syphilis* ; Syphilis, Cutaneous ; Syphilis, Latent

BACKGROUND: The syphilis diagnostic algorithms applied in different countries vary significantly depending on the local syphilis epidemiology and other considerations, including the expected workload, the need for automation in the laboratory and budget factors. This study was performed to investigate the efficacy of traditional and reverse syphilis diagnostic algorithms during general health checkups. METHODS: In total, 1,000 blood specimens were obtained from 908 men and 92 women during their regular health checkups. Traditional screening and reverse screening were applied to the same specimens using automatic rapid plasma regain (RPR) and Treponema pallidum latex agglutination (TPLA) tests, respectively. Specimens that were reverse algorithm (TPLA) reactive, were subjected to a second treponemal test performed by using the chemiluminescent microparticle immunoassay (CMIA). RESULTS: Of the 1,000 specimens tested, 68 (6.8%) were reactive by reverse screening (TPLA) compared with 11 (1.1%) by traditional screening (RPR). The traditional algorithm failed to detect 48 specimens [TPLA(+)/RPR(−)/CMIA(+)]. The median TPLA cutoff index (COI) was higher in CMIA-reactive cases than in CMIA-nonreactive cases (90.5 vs 12.5 U). CONCLUSIONS: The reverse screening algorithm could detect the subjects with possible latent syphilis who were not detected by the traditional algorithm. Those individuals could be provided with opportunities for evaluating syphilis during their health checkups. The COI values of the initial TPLA test may be helpful in excluding false-positive TPLA test results in the reverse algorithm.
Agglutination ; Automation ; Budgets ; Epidemiology ; Female ; Humans ; Immunoassay ; Latex ; Male ; Mass Screening* ; Plasma ; Syphilis* ; Syphilis, Latent ; Treponema pallidum