Primary seropositive syphilis with acute condylomas of the facial skin and perianal candidiasis

Syphilis is an infectious human disease caused by pale treponema (Treponema pallidum), transmitted mainly by sexual intercourse and characterised by a progressive course with periodisation of clinical symptoms and lesions of the skin, mucous membranes, nervous system, internal organs and musculoskeletal apparatus, the incidence of which remains an important and urgent problem requiring medical alertness.

The current data and the main trends of syphilis morbidity in the Russian Federation for several years (from 2019 to 2023) are analyses in detail in the article. It is established that the number of new cases of the infectious disease has increased over the specified time period. The COVID-19 pandemic had a particular impact on syphilis morbidity statistics. In addition, the introduction of additional measures, such as mandatory testing of foreign citizens for dangerous infections, including syphilis, with mandatory submission of the results to the Ministry of Internal Affairs of the Russian Federation also had an impact on the statistics of morbidity.

We present a unique clinical case that demonstrates the presence of primary seropositive syphilis (perianal chancres) in a male patient with acute condylomas of the facial skin and perianal candidiasis. Initially, a coloproctologist made an incorrect diagnosis, despite the history (unprotected sexual intercourse), the characteristic clinical picture of the disease and the specific localisation of the rashes, indicating the site of the pathogen's introduction. The diagnosis was confirmed by positive results of nontreponemal test, specific treponemal tests and passive haemagglutination reaction. Pale treponema was also detected by dark-field microscopy. Due to aggravated allergological anamnesis ― intolerance to penicillin antibiotics ― specific antisyphilitic treatment with ceftriaxone was prescribed. According to the results of control analyses, the treatment was positive. Acute condylomas of the facial skin were removed by the radio wave method after complex treatment of the underlying disease. After completion of the specific treatment, it was recommended to carry out clinical and serological control once every 3 months.