Increasing Trends of Syphilis and Histopathological Correlates: Study in a Tertiary Care Centre in India

Background: Syphilis is a venereal disease with multisystem manifestations resulting from infection with bacterium Treponema Pallidum.(1) Syphilis is categorized as Primary, secondary, tertiary and Congenital forms.(2), (3).We aim to expose the increasing trend of this bygone malady and how histopathology can sometimes not only aid in confirmation but diagnosis of a clinically unsuspected case. Syphilis has come to the limelight as a public health hazard as seen in our centre. Aims: To find out the rising trends in the presentation of syphilis and to analyze the histopathological clues for the diagnosis in skin biopsies. Subjects and Methods: We analyzed the case records of all cases of STDs with special emphasis on Syphilis registered in the department of Dermatology and Venerology. A diagnosis of Syphilis was predominantly made based on clinical and serological grounds. However, in some, histopathology of skin proved to be path breaker in the diagnosis of this great mimic. Here in we analysed the histopathological characteristics of the same. Results: Among the STI cases examined the most commonly found STI was Syphilis (57%) followed by Genital warts (22%) .70% were Males and 79% were in the age group of 21-30 years and least in the 81-90 years (0.05%).3 cases (1.51%) were of congenital syphilis Syphilis had varied skin manifestations at various stages detected by Histopathological examination. Implication of the study: Syphilis is a systemic disease caused by the spirochaete Treponema pallidum (TP) and is one of the oldest known diseases. It has now re-emerged as a cause of public health concern in the modern-day world. Syphilis causes histologic features of the affected tissue depending on the type of lesion and the stage of the disease. We have seen that some cases could have come to the limelight in the era of Covid -19 pandemic in an other unsuspected case and there has been an increasing trend in the post covid era.