Syphilis is a sexually transmitted infection that has recently seen a resurgence within the gay and men who have sex with men community as a sexual health concern.
Syphilis is caused by a small spirochete bacteria that enters the body via broken skin.
There are three stages to infection:
- Primary Syphilis. This presents with a small painless sore, a “chancre” that shows up where the bacteria entered the body. This can be found almost anywhere on the body such as the penis, in or around the anus, in the mouth and even on regular skin where you would not consider as part of normal sexual contact. While this chancre is present the spirochetes can be easily transmitted to another person by touching broken skin. This sore will present a week or so after infection and will go away after 6-8 weeks.
- Secondary Syphilis presents with a head to toe rash. It can be itchy however is not always so. This rash does not respond well to topical steroids despite frequently looking like dermatitis. Secondary syphilis comes if the primary infection was missed and not treated. The rash is highly infectious and will present 2-3 months after the primary sore has healed.
- Tertiary Syphilis is thankfully very rare. This presents with changes to the brain and thought process thus “neuro syphilis” is associated with neurocognitive changes.This can present many years after initial infection.
For this reason regular sexual health screening is vital to catch Syphilis as there may be no obvious symptoms of infection.
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