{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:49:00Z","timestamp":1792270140637,"version":"4.4.0"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medical Case Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p> Syphilis is a sexually transmitted infection that is undergoing a resurgence in Canada and around the world. If not diagnosed correctly, syphilis can progress to its secondary and tertiary stages, affecting numerous organ systems. We present a case of a 41-year-old female who developed a papulosquamous rash, initially diagnosed as varicella with progression to a widespread and painful rash over 3 months. Based on clinical, histological, and serological findings, she was later diagnosed with secondary syphilis and successfully treated with intramuscular penicillin. This case underscores the importance of accurate diagnosis and treatment of syphilis to prevent systemic complications. We advocate for increased awareness among frontline providers with a proactive approach to diagnosis and management, including thorough history and physical examination, low threshold for performing serological testing, biopsy for lesions that do not resolve as expected with management, and multidisciplinary involvement for complex presentations of syphilis. <\/jats:p>","DOI":"10.1177\/2050313x241289591","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T17:11:26Z","timestamp":1729098686000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Increasing incidence of syphilis: A case report of non-resolving papulosquamous rash and role of a biopsy in the prevention of delayed diagnosis"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3138-3221","authenticated-orcid":false,"given":"Barinder K","family":"Bajwa","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad R","family":"Brown","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazdan","family":"Mirzanejad","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"Fraser Health, Surrey Memorial Hospital, Surrey, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8053-2027","authenticated-orcid":false,"given":"Carolyn J","family":"Shiau","sequence":"additional","affiliation":[{"name":"Fraser Health, Surrey Memorial Hospital, Surrey, BC, Canada"},{"name":"Department of Pathology, Royal Columbian Hospital, New Westminster, BC, Canada"},{"name":"Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada"},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"bibr1-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v48i23a01"},{"key":"bibr2-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.3499"},{"key":"bibr3-2050313X241289591","unstructured":"GOV.UK. Gonorrhoea and syphilis at record levels in 2022, https:\/\/www.gov.uk\/government\/news\/gonorrhoea-and-syphilis-at-record-levels-in-2022 (2023, accessed 10 April 2024)."},{"key":"bibr4-2050313X241289591","unstructured":"CATIE. A resurgence of syphilis in Canada: Who is being affected most and what interventions are needed? Canada\u2019s source for HIV and hepatitis C information, https:\/\/www.catie.ca\/prevention-in-focus\/a-resurgence-of-syphilis-in-canada-who-is-being-affected-most-and-what (2021, accessed 10 April 2024)."},{"key":"bibr5-2050313X241289591","unstructured":"Canada PHA. Syphilis guide: risk factors and clinical manifestations, https:\/\/www.canada.ca\/en\/public-health\/services\/infectious-diseases\/sexual-health-sexually-transmitted-infections\/canadian-guidelines\/syphilis\/risk-factors-clinical-manifestation.html (2021, accessed 10 April 2024)."},{"key":"bibr6-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.2.187"},{"key":"bibr7-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1071\/SH14174"},{"key":"bibr8-2050313X241289591","first-page":"3","volume":"35","author":"Gjestland T","year":"1955","journal-title":"Acta Derm Venereol Suppl (Stockh)"},{"key":"bibr9-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1136\/sti.74.2.95"},{"key":"bibr10-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1086\/513427"},{"key":"bibr11-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.11.1510"},{"key":"bibr12-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.3.388"},{"key":"bibr13-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200207050-00017"},{"key":"bibr14-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1097\/01.olq.0000168280.34424.58"},{"key":"bibr15-2050313X241289591","unstructured":"Western News. Expert insight: Why are syphilis cases on the rise in Canada? https:\/\/news.westernu.ca\/2024\/02\/expert-insight-why-are-syphilis-cases-on-the-rise-in-canada\/ (2024, accessed 13 April 2024)."},{"key":"bibr16-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2008.04.002"},{"key":"bibr17-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.3390\/venereology2020006"},{"key":"bibr18-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1987.tb00532.x"},{"key":"bibr19-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2021.01.025"},{"key":"bibr20-2050313X241289591","doi-asserted-by":"publisher","DOI":"10.5070\/D3390280M2"},{"key":"bibr21-2050313X241289591","volume-title":"Dermatology","author":"Bolognia JL","year":"2012","edition":"3"}],"container-title":["SAGE Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X241289591","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X241289591","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X241289591","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T15:24:16Z","timestamp":1741015456000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X241289591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":21,"alternative-id":["10.1177\/2050313X241289591"],"URL":"https:\/\/doi.org\/10.1177\/2050313x241289591","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"2050313X241289591"}}