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The definition of malignant syphilis has not been updated since it was first described as only a cutaneous manifestation. In recent years, syphilis has reemerged as a major public health issue, particularly in men who have sex with men (MSM) and patients with HIV. With increasing rates of syphilis in the HIV\u2010positive population, the systemic manifestations of malignant syphilis have become more apparent. We propose a revised definition and elucidate why the term malignant syphilis should be expanded to include systemic manifestations, stressing musculoskeletal, central nervous system, ocular, ear, cardiovascular, rectal, liver, lung, and renal involvement. This updated definition is dramatically expanded to reflect its systemic manifestations. Recognition of these manifestations may prevent devastating long\u2010term effects.<\/jats:p>","DOI":"10.1111\/ijd.16444","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T10:00:22Z","timestamp":1666000822000},"page":"369-375","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Malignant syphilis: a new and revised definition"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7312-8297","authenticated-orcid":false,"given":"Katrice M.","family":"Karanfilian","sequence":"first","affiliation":[{"name":"Dermatology Stony Brook University Hospital  Stony Brook NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer Ali","family":"Almohssen","sequence":"additional","affiliation":[{"name":"Dermatology Alfardan Medical\/Northwestern Medicine  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra","family":"Kapila","sequence":"additional","affiliation":[{"name":"Infectious Disease Rutgers New Jersey Medical School  Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3036-3825","authenticated-orcid":false,"given":"Robert A.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Dermatology and Pathology Rutgers New Jersey Medical School  Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.73"},{"key":"e_1_2_4_3_1","unstructured":"BazinE.Le\u00e7on Theorique et Cliniques sur les Syphilides Rediqu\u00e9es par le Fournier;1859."},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197703242961220"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.161197"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20164491"},{"key":"e_1_2_4_7_1","first-page":"11","article-title":"Malignant syphilis","volume":"9","author":"Neisser A","year":"1897","journal-title":"Br J Dermatol"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-193408000-00039"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ad.2018.09.023"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i16.2406"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.11.1510"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.15698\/mic2016.09.523"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1901593"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa019"},{"key":"e_1_2_4_15_1","unstructured":"Centers for Disease Control and Prevention.Syphilis. 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