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: Definite criteria for the diagnosis and treatment evaluation for different clinical stags of syphilis are not yet present dute to the inability to dultivate Treponema pallidum in vitro. However, as the staining methods and the serological tests currently used have their limitations, a more definite method for its confirmation is needed. Polymerase chain reaction (PCR), due to its high sensitivity and specificity, is currently being applied to the detection of T. pallidum. OBJECTIVE: We have used PCR for the detection of T. pallidum DNA in various clinical specimens in orber to evaluate its potenital as a diagnostic tool. METHOD: Clinical specimens were collected from patients with different stages of syphilis who visited ithe Deparment of Dermatology of Yonsei medical Center for 1 year beginning from May, 1991. Sera from 63 patients, cerebrospinal fluids from 24 patients, amniotic fluids from 3 patients, and 21 tissues from 19 patients were subjected to PCR and the results were analyzed to evaluate its usefulness as a diagnostic and treatment evaluation tool. A portion of the T. pallidum-specific chromosomal DNA, tpp47, which encodes the 47 kDa surface protein, was used as the template DNA to amplify the 658 bp DNA fragment, and the following results were obtained. PCR using primers 47-1 and 47-2 were applied to amplify 658 bp DNA fragments from the T. pallidum-specific tpp47 gene encoding 47 kDa surface protein. RESULT: 1. To evaluate the sensitivity of the PCR, T. pallida and their chromosomal DNA were diluted. The diluents contataining a single organism and 1 fg of the chromosomal DNA showed positive reactions by the amplification. 2. Specificity of the PCR was determined by using T. pallidum, 4 species beloging to genus Treponema, and 9 species of nonpathogenic or pathogenic organisms. A positive reaction was obtained only when T. pallidum chromosomal DNA was used. 3. PCR was positive in 5 of 9 (55%) sera in primary syphilis, 22 of 26(84%) in secondary syphilis, 3 to 15(20%) in early latent syphilis, 1 of 19 (11%0 in late latent syphilis, 2 of 2 (100%) in neurosyphlis, and 0 of 2 (0%) in congenital syphilis. The differences in the positive rates were statistically significant (P<0.01) in all stages except neurosyphilis and congenital syphilis, as their numbers were too smalll to deduce any significant meaning. Despite their high VDRL titers, the positive rate in early latent syphilis was relatively low when compared to the rate in secondary syphilis. 4. Follw-up PCR of sera in some patients showed positive results 9 months after treatment. However, some with negative PCR before treatment showed positive results after treatment. 5. PCR was positive in 1 of 1 (50%) cerebrospinal fluid in primary syphilis, 3 of 14 (21%) in secondary syphilis, 2 of 7 (29%) in early latent syphilis, and 1 of 1(100%) in neurosyphlis. The differences in the positive rates showed no statistical significance in relation to the clinical stages. Cerebrospinal fluid VDRL test, white blood cell count, and protein content showed no correlation to the PCR results in early syphilis patients. 6. Amniotic fluid showed a positive PCR result only in a pregnant woman whose serum showed a high VDRL titer and a positive PCR. 7. PCR positive rates were 90% in frozed tissues and 50% in paraffin embedded tissues. CONCLUSION: From the results, it is suggested that PCR is not suitable for treatment evaluation but is useful for the detection of T. pallidum in sera of secondary syphilis patients and syphilitic lesions, and for the confirmation of the diagnosis the diagnosis in these cases.
Amniotic Fluid ; Cerebrospinal Fluid ; Dermatology ; Diagnosis ; DNA ; Female ; Humans ; Leukocyte Count ; Neurosyphilis ; Paraffin ; Polymerase Chain Reaction* ; Pregnant Women ; Sensitivity and Specificity ; Serologic Tests ; Syphilis ; Syphilis, Congenital ; Syphilis, Latent ; Treponema pallidum* ; Treponema*

Neurosyphilis is a rare infection of the brain and spinal cord caused by a spirochete named Treponema pallidum. We describe the magnetic resonance imaging of a 53-year-old man with syphilis who manifested as both meningovascular, and spinal meningomyelitic types, which involved the optic, trigeminal, facial and vestibulocochlear nerves, both middle and left posterior cerebral arteries, thoracic spinal cord and meninges of the lumbar spine. This case report suggests that neurosyphilis should be considered as a possible diagnosis in patients showing complex brain and spinal imaging features. These features include enhancing meningeal lesions with multiple cranial nerve involvement, stenoses in large to medium size cerebral arteries, and intramedullary and meningeal lesions of spine.
Brain ; Cerebral Arteries ; Cerebral Infarction* ; Constriction, Pathologic ; Cranial Nerve Diseases* ; Cranial Nerves ; Diagnosis ; HIV* ; Humans ; Magnetic Resonance Imaging* ; Meninges ; Meningitis ; Middle Aged ; Neurosyphilis* ; Posterior Cerebral Artery ; Spinal Cord ; Spine ; Spirochaetales ; Syphilis ; Tabes Dorsalis ; Treponema pallidum ; Vestibulocochlear Nerve

OBJECTIVETo identify the frequency of syphilis among Iranian HIV-positive patients.

METHODSA cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected.

RESULTSOf all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis.

CONCLUSIONSConsidering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.

Coinfection ; Cross-Sectional Studies ; HIV Infections ; epidemiology ; transmission ; Humans ; Iran ; epidemiology ; Prevalence ; Risk Factors ; Syphilis ; epidemiology ; Treponema pallidum ; Treponemal Infections ; epidemiology ; transmission

3775 pregnant women attending Tu Du maternal hospital in the period 1995-1997 were randomly included in the study. The results showed that, 3 pregnant women (0.1%) had HIV seropositivity, 290 (7.7%) HBsAg positivity, 21 (0.6%) treponema infection. Among 293 sera screened for toxoplasma infection, there were 17 seropositive cases (16%). History of blood transfusion were found to be factors associated with treponema seropositivity by univariable analysis
HIV, Seroepidemiologic Studies ; Hepatitis B ; toxoplasmosis ; Treponemal Infections ; pregnant women

This paper is studied for statistical anaIysis of 1181 cascs of positive V.D.R.L test among 24414 cases who were visited for annual Physical examination and in or outpatients in the Han Gang Sung Shim Hospital during 5 years and 7 months from January 1972 to July 1977. Clinical survey was carried out with 182 syphilitic patients in the Department of Dermatology, Han Gang Sung Shim Hospital during 19 months from January l976 to July 1977. The results were as follows; 1. Positive rate for V.D.R.L test was 4.8%, and there were statistically significant differences in annual incidence(P<0.01). Biologic false positive rate for V.D.R.L test was 26. 7%, and there were statistically aignificant differences in annual incidence(P<0.01). 2. Departmental analysis such as Dermatology, Urology, Physical Examination and others including Obstetrics and Gynecology, Internal Medicine, Pediatrics etc. were carried out, the results showed that there were statistically significant departmental differences in V.D.R.L positive rate, but no in biologic false positive rate. 3. Biologic false positive rate was high inversely proportional to dilution titer, and that was a statistically significant difference(P<0.01). 4. 182 had syphilis, of whom 106(58. 2%) were latent syphilis and 74(40. 7%) were primary and secondary syphilis. 5. 119(65. 4%) among 182 syphilitic patients were male, most of patients(87.8%) occured in age from 21 to 40 years in the both sex. But there no statistically significant differences in age distribution between males and females. 6. The most predilection site of chancre was coronary sulcus(54.5%). 7. The lesions of secondary syphilis were composed of 18 cases(25%) of condyloma latum, 17 cases(23. 6%) of roseolar syphilid, 17 cases of papulo-squamous syphilid, 13 cases of alopecia syphilitica, 1 case of pustular syphilid, and 6 cases of others. 8. Married patients were nearly two times than single. In women, married. patients were much more(80. 3%) than single, and there were statistically significatnt differences(P<0.01). 9. There were no significant differences in S.T.S positive rate of spouse between infectious and latent syphilis. 10. Occupation distribution of male sexual partners were composed of 35 cases(29. 4%) of waitress, 28 cases(23. 5%) of call-girl, 20 cases(16. 8%) of office-girl, 17 cases of housewife, 12 cases of out of work, 7 cases of student. 1I. For patients with primary, secondary, and latent syphilis, treatment consiste of benzathine penicillin 2. 4 million units intramuscularly on the first visit and repeated three penicillin preparations at 7 days intervals in most of patients.
Age Distribution ; Alopecia ; Chancre ; Dermatology ; Female ; Gynecology ; Humans ; Internal Medicine ; Male ; Obstetrics ; Occupations ; Outpatients ; Pediatrics ; Penicillin G Benzathine ; Penicillins ; Physical Examination ; Serologic Tests* ; Sexual Partners ; Spouses ; Syphilis* ; Syphilis, Cutaneous ; Syphilis, Latent ; Urology

85 cases of neurosyphilis were observed in Seoul National University Hospital over 6-year period (1979-1984). They were analyzed with respect to clinical symptoms and signs in individual types, serological data in both blood and CSF, changes of cytochemical compositions in CSF, and other significant findings. And some coparisons with other reports were made. They ranged from 22 to 66 years in age with the peak incidence in the forties (41%). Ratio of male to female was observed to be 4.3:1. There were 27 cases of asymptomatic neurosyphilis (NS) (32%), 14 cases of tabes dorsalis (16%), 18 cases of general paresis (21%), 2 cases of taboparesis (2%), 7cases of vascular NS (8%), 6 cases of meningeal NS (7%), 4 cases of syphilitic eight nerve involvement (5%), 4 cases of late syphilitic ocular involvement including optic atrophy (5%), and 3 cases of spinal form (4%). Except in 4 self-referral cases, alimentary system symptoms or illnesses were the main prolbems in asymptomatic neurosyphilitics (48%). Most symptomatic cases had the similar clinical pictures as described in the previous reports but some cases appeared to be combined with symptoms and signs of different types. In tabes dorsalis, patients presented paresthesia and hypoactive DTRs in lower limbs as the most frequent features. According to predominant manifestations, there were 4 cases of dementic form and 14 cases of psychotic form in general paresis but in most cases both features overlapped each other. In 8 cases of general paresis brain CT scans were performed, which revealed diffuse cerebral atrophy in five. Focal abnormalities of vascular NS were most frequently found in temporal areas (4 in 7 cases). Meningeal irritation signs were observed only in one among 6 cases 6 meningeal NS. All cases of eighth nerve involvement showed sensorineural hearing loss at high-tone level. Compared with TPHA, which was used as a criterion for the patient selection, VDRL reactivity was 98% in serum and 49% in CSF. It is notable that as for general paresis and meningeal NS, higher reactivity and elevated titers of CSF VDRL were associated with increase of cells and total protein in CSF, suggesting higher disease activity in both types. Unlike those from other countries, the domestic studies including this report show that general paresis occupies a relatively higher proportion than tabes dorsalis in Korea.
Atrophy ; Brain ; Digestive System ; Female ; Hearing Loss, Sensorineural ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Neurosyphilis* ; Optic Atrophy ; Paresthesia ; Patient Selection ; Seoul ; Tabes Dorsalis ; Tomography, X-Ray Computed

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

No abstract available.
Syphilis, Congenital*