{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T03:22:54Z","timestamp":1768274574996,"version":"3.49.0"},"reference-count":56,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T00:00:00Z","timestamp":1452556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Syphilis is an ancient disease that has re\u2010emerged in the last decade. It is prevalent among men who have sex with men and has increased in incidence with certain ethnic groups. It usually presents as primary or secondary syphilis and can progress to tertiary syphilis if not treated. Primary syphilis will classically manifest as a single, painless ulcer with smooth, clean, and raised borders on the genitals or less often on the oral mucosa. Unusual primary syphilis cases have been reported and can be easily misdiagnosed with a resulting delay of treatment. Secondary syphilis is a systemic disease, wherein the treponemes have disseminated to various organ systems, typically presenting with characteristic mucocutaneous lesions. Tertiary syphilis has a higher rate of morbidity and mortality; as such, the aim of this article is to provide the readers with tools to recognize early syphilis and prevent its progression to late stages. In this review, we present a likely case of unusual primary syphilis mimicking herpes progenitalis as well as a compilation of all atypical cases of primary syphilis from 1973 to 2015. We will also review the differential diagnosis, management, and recommendations for each stage of syphilis.<\/jats:p>","DOI":"10.1111\/ijd.13206","type":"journal-article","created":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T00:54:42Z","timestamp":1452646482000},"page":"714-728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Unusual primary syphilis: Presentation of a likely case with a review of the stages of acquired syphilis, its differential diagnoses, management, and current recommendations"],"prefix":"10.1111","volume":"55","author":[{"given":"Paula J.","family":"Watts","sequence":"first","affiliation":[{"name":"Kansas City University of Medicine and Biosciences Kansas City MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry L.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"University of Nevada Las Vegas NV USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amor","family":"Khachemoune","sequence":"additional","affiliation":[{"name":"Department of Dermatology Veterans Affairs Medical Center Brooklyn and SUNY Downstate Brooklyn NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1016\/B978-1-4557-4801-3.00239-3","volume-title":"Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases","author":"Radolf JD","year":"2015"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39085.518148.BE"},{"key":"e_1_2_6_4_1","unstructured":"World Health Organization Department of HIV\/AIDS.Global Prevalence and Incidence of Selected Curable Sexually Transmitted Infections Overview and Estimates (www document).2001. URLhttp:\/\/whqlibdoc.who.int\/hq\/2001\/WHO_HIV_AIDS_2001.02.pdf?ua=1(accessed on 9 January 2015)."},{"key":"e_1_2_6_5_1","unstructured":"PattonM SuJ NelsonR et\u00a0al.Primary and Secondary Syphilis \u2013 United States 2005\u20132013(www document).2014. URLhttp:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6318a4.htm(accessed on 23 December 2015)."},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/01.olq.0000149848.03733.c1","article-title":"The re\u2010emergence of syphilis in the UK: the new epidemic phases","volume":"32","author":"Simms I","year":"2005","journal-title":"Sex Transm Dis"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001432-199802000-00012"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2010.22.2.126"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199911120-00011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200203290-00013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200207260-00011"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200003010-00010"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000127027.55052.22"},{"key":"e_1_2_6_14_1","first-page":"178","article-title":"Critical review of empirical research dealing with the relationship between optimistic tendencies and HIV related behaviors","volume":"17","author":"Santillan Torres Torija C","year":"2010","journal-title":"Suma Psicol"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2012.24.2.91"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.070417"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200401230-00021"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.215"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-0070(84)80009-1"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1258\/095646206778691185"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-197804000-00009"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1586\/14787210.3.5.825"},{"key":"e_1_2_6_23_1","first-page":"1922","volume-title":"Goldman\u2010Cecil Medicine","author":"Goldman L","year":"2012"},{"key":"e_1_2_6_24_1","first-page":"102","volume-title":"Dermatopathology","author":"Chen HM","year":"2015"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2008.10.017"},{"key":"e_1_2_6_26_1","first-page":"607921","article-title":"Diagnosis\/classification criteria for Beh\u00e7et's disease","volume":"2012","author":"Davatchi F","year":"2012","journal-title":"Patholog Res Int"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000125"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0805-3"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1990.30991048793.x"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2004.07.009"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1903"},{"key":"e_1_2_6_32_1","first-page":"801","volume-title":"Concise Pathology","author":"Chandrasoma P","year":"1998"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00834-10"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-81-322-1774-9_5"},{"key":"e_1_2_6_35_1","unstructured":"FDA News Release.FDA grants CLIA waiver expanding the availability of rapid screening test for syphilis. (www document).2014. URLhttp:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm426843.htm(accessed on 26 February 2015)."},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.13259"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268814002830"},{"key":"e_1_2_6_38_1","unstructured":"Centers for Disease Control and Prevention (CDC).Syphilis. 2015 Sexually Transmitted Diseases Treatment Guidelines(www document).2015. URLhttp:\/\/www.cdc.gov\/std\/tg2015\/syphilis.htm(accessed on 26 July 2015)."},{"key":"e_1_2_6_39_1","first-page":"133","article-title":"Discordant results from reverse sequence syphilis screening: five laboratories, United States, 2006\u20102010","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000121204.58881.60"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1993.00410210124014"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu325"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe058161"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1086\/500406"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2013.04.001"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)00330-7"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1159\/000251888"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2012.06.013"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200607050-00003"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-226"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1979.04010020065022"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2009.008463"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2004.01.029"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.12058"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462414551235"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2008.008085"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1258\/095646207781147346"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijd.13206","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.13206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T16:53:55Z","timestamp":1696352035000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.13206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,12]]},"references-count":56,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1111\/ijd.13206"],"URL":"https:\/\/doi.org\/10.1111\/ijd.13206","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,12]]},"assertion":[{"value":"2015-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}