{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T03:36:32Z","timestamp":1752982592166,"version":"3.37.3"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"7-8","license":[{"start":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T00:00:00Z","timestamp":1656720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,22]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>The diversity of the cutaneous manifestations of syphilis and the ability of the spirochete to evade diagnosis have been well documented by medical literature. However, what triggers the onset of secondary syphilis is not yet clear because of difficulties studying the bacterium. Our case describes the onset of a heterogeneous rash (or coexisting rashes) that presented the day after vaccination with the Moderna mRNA-1273 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. The potential etiologies of the patient\u2019s rash: A vaccine reaction, reactivation of chronic spontaneous urticaria, or a physical sign of syphilis itself are then reviewed. The potential for the Moderna coronavirus disease 2019 (COVID-19) vaccine to be the catalyst of this patient\u2019s cutaneous manifestations of his immune system responses is also hypothesized.<\/jats:p>","DOI":"10.1093\/milmed\/usac191","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T05:36:10Z","timestamp":1656740170000},"page":"2829-2832","source":"Crossref","is-referenced-by-count":3,"title":["Secondary Syphilis Presentation and Urticarial Eruption After Moderna COVID-19 Vaccination"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-631X","authenticated-orcid":false,"given":"Aaron","family":"Brockshus","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Evans Army Community Hospital , Fort Carson, CO 80913, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin O","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology, Blanchfield Army Community Hospital , Fort Campbell, KY 42223, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandra","family":"Punch","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology, Evans Army Community Hospital , Fort Carson, CO 80913, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,7,2]]},"reference":[{"issue":"1","key":"2023072301104820800_R1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1007\/s40471-018-0138-z","article-title":"An update on the global epidemiology of syphilis","volume":"5","author":"Kojima","year":"2018","journal-title":"Curr Epidemiol Rep"},{"author":"Center for Disease Control and Prevention","key":"2023072301104820800_R2","article-title":"Sexually transmitted disease surveillance 2020"},{"issue":"1","key":"2023072301104820800_R3","doi-asserted-by":"publisher","first-page":"143","DOI":"10.2174\/1874279301004010143","article-title":"Syphilis: a review of the diagnosis and treatment","volume":"3","author":"Emerson","year":"2009","journal-title":"Open Infect Dis J"},{"issue":"2","key":"2023072301104820800_R4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1128\/CMR.12.2.187","article-title":"Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features","volume":"12","author":"Singh","year":"1999","journal-title":"Clin Microbiol Rev"},{"issue":"12","key":"2023072301104820800_R5","doi-asserted-by":"publisher","first-page":"4584","DOI":"10.1172\/JCI57173","article-title":"Syphilis: using modern approaches to understand an old disease","volume":"121","author":"Ho","year":"2011","journal-title":"J Clin Invest"},{"issue":"5","key":"2023072301104820800_R6","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/DAD.0b013e3181e8b587","article-title":"The immunopathobiology of syphilis: the manifestastions and course of syphilis are determined by the level of delayed-type hypersensitivity","volume":"33","author":"Carlson","year":"2011","journal-title":"Am J Dermatopathol"},{"issue":"3","key":"2023072301104820800_R7","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.clindermatol.2019.01.007","article-title":"Syphilis: a great imitator","volume":"37","author":"Cakmak","year":"2019","journal-title":"Clin Dermatol"},{"issue":"1","key":"2023072301104820800_R8","doi-asserted-by":"publisher","DOI":"10.1186\/1939-4551-7-31","article-title":"Chronic urticaria: new management options","volume":"7","author":"Greenberger","year":"2014","journal-title":"World Allergy Organ J"},{"issue":"1","key":"2023072301104820800_R9","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1128\/CMR.18.1.205-216.2005","article-title":"Secondary syphilitic lesions","volume":"18","author":"Baughn","year":"2005","journal-title":"Clin Microbiol Rev"},{"issue":"50","key":"2023072301104820800_R10","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.191075","article-title":"Syphilis imitating urticarial vasculitis","volume":"191","author":"Miyachi","year":"2019","journal-title":"CMAJ"},{"issue":"5","key":"2023072301104820800_R11","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/ACI.0b013e32830f9119","article-title":"Update on chronic urticaria: focusing on mechanisms","volume":"8","author":"Mlynek","year":"2008","journal-title":"Curr Opin Allergy Clin Immunol"},{"issue":"9","key":"2023072301104820800_R12","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.18102","article-title":"Chronic spontaneous urticaria after COVID-19 vaccine","volume":"13","author":"Thomas","year":"2021","journal-title":"Cureus"},{"key":"2023072301104820800_R13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/21526567211068458","article-title":"Chronic spontaneous urticaria triggered by the AstraZeneca\/Oxford COVID-19 vaccine with achieved remission: a case report","volume":"13","author":"Brooks","year":"2022","journal-title":"Allergy Rhinol"},{"author":"Center for Disease Control and Prevention","key":"2023072301104820800_R14","article-title":"The vaccine adverse event reporting system (VAERS) request"},{"issue":"5","key":"2023072301104820800_R15","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1016\/j.jaci.2014.02.036","article-title":"The diagnosis and management of acute and chronic urticaria: 2014 update","volume":"133","author":"Bernstein","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"2023072301104820800_R16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/21526567211026271","article-title":"Two cases of well controlled chronic spontaneous urticaria triggered by the moderna COVID-19 vaccine","volume":"3","author":"Alflen","year":"2021","journal-title":"Allergy Rhinol"},{"key":"2023072301104820800_R17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2014\/674709","article-title":"Pathogenesis of chronic urticaria: an overview","volume":"2014","author":"Jain","year":"2014","journal-title":"Dermatol Res Pract"},{"issue":"6","key":"2023072301104820800_R18","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1086\/511822","article-title":"Treponema pallidum elicits innate and adaptive cellular immune responses in skin and blood during secondary syphilis: a flow-cytometric analysis","volume":"195","author":"Salazar","year":"2007","journal-title":"J Infect Dis"},{"issue":"2","key":"2023072301104820800_R19","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9020147","article-title":"SARS-CoV-2 mRNA vaccines: immunological mechanism and beyond","volume":"9","author":"Bettini","year":"2021","journal-title":"Vaccines"},{"issue":"4","key":"2023072301104820800_R20","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1038\/s41577-021-00526-x","article-title":"COVID-19 vaccines: modes of immune activation and future challenges","volume":"21","author":"Teijaro","year":"2021","journal-title":"Nat Rev Immunol"},{"issue":"4","key":"2023072301104820800_R21","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1038\/nrd.2017.243","article-title":"mRNA vaccines \u2013 a new era in vaccinology","volume":"17","author":"Pardi","year":"2018","journal-title":"Nat Rev"},{"issue":"5","key":"2023072301104820800_R22","doi-asserted-by":"publisher","first-page":"2421","DOI":"10.2353\/ajpath.2010.100277","article-title":"Host defense mechanisms in secondary syphilitic lesions a role for IFN-y-\/IL-17-producing CD8+ T cells?","volume":"177","author":"Stary","year":"2010","journal-title":"Am J Pathol"},{"issue":"7","key":"2023072301104820800_R23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001717","article-title":"Immune evasion and recognition of the syphilis spirochete in blood and skin of secondary syphilis patients: two immunologically distinct compartments","volume":"6","author":"Cruz","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"2023072301104820800_R24","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1016\/s1286-4579(02)01638-6","article-title":"The immune response to infection with Treponema pallidum, the stealth pathogen","volume":"4","author":"Salazar","year":"2002","journal-title":"Microbes Infect"},{"author":"United States Food and Drug Administration","key":"2023072301104820800_R25","article-title":"Possible false RPR reactivity with BioPlex 2200 syphilis total and RPR test kit following a COVID-19 vaccine-letter to clinical laboratory staff and health care providers"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/7-8\/2829\/50937444\/usac191.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/7-8\/2829\/50937444\/usac191.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T01:16:30Z","timestamp":1690074990000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/188\/7-8\/2829\/6627166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,2]]},"references-count":25,"journal-issue":{"issue":"7-8","published-online":{"date-parts":[[2022,7,2]]},"published-print":{"date-parts":[[2023,7,22]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usac191","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2023,7,1]]},"published":{"date-parts":[[2022,7,2]]}}}