{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:32:39Z","timestamp":1786739559737,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Syphilis is a systemic human infection which is caused by\n                    <jats:italic toggle=\"yes\">Treponema pallidum<\/jats:italic>\n                    , a spirochete. It is an obligate human pathogen, which is renowned for its immune-evasiveness. It is one of the most common sexually transmitted infection that present as genital ulcer disease. The classic ulcerative lesion of syphilis is referred to as a painless hard chancre. This description can mislead inexperienced physicians when syphilis presents atypically. Traditionally, syphilis has been referred to as \u201cthe great imitator\u201d owing to its myriad and multisystem involvement. We present a case series of eleven patients who presented with multiple, polysized or herpetiform ulcers over the genitalia and in whom the diagnosis of syphilis was eventually confirmed.\n                  <\/jats:p>","DOI":"10.4103\/ijstd.ijstd_167_25","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T14:01:12Z","timestamp":1779199272000},"page":"57-60","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Is the great imitator back? A case series on atypical presentation of primary syphilis as multiple herpetiform ulcers"],"prefix":"10.4103","volume":"47","author":[{"given":"Renu","family":"Kandpal","sequence":"first","affiliation":[{"name":"Department of Dermatology, Base Hospital, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Pathania","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Base Hospital, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyanesh","family":"Rathore","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Base Hospital, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pathology, Base Hospital, Bagdogra, Darjeeling, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"R1-20260626","doi-asserted-by":"crossref","first-page":"17073","DOI":"10.1038\/nrdp.2017.73","article-title":"Syphilis","volume":"3","author":"Peeling","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20260626","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1056\/NEJMra1901593","article-title":"The modern epidemic of syphilis","volume":"382","author":"Ghanem","year":"2020","journal-title":"N Engl J Med"},{"key":"R3-20260626","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.abd.2020.03.008","article-title":"Atypical manifestations of recent syphilis: Study of 19 cases","volume":"95","author":"Sardinha","year":"2020","journal-title":"An Bras Dermatol"},{"key":"R4-20260626","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1258\/ijsa.2008.008398","article-title":"Mondor's disease of the penis associated with primary syphilis","volume":"20","author":"Rani","year":"2009","journal-title":"Int J STD AIDS"},{"key":"R5-20260626","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.3390\/jcm13061603","article-title":"Atypical manifestations of syphilis: A 10-year retrospective study","volume":"13","author":"Ciccarese","year":"2024","journal-title":"J Clin Med"},{"key":"R6-20260626","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1136\/sextrans-2015-052219","article-title":"Painful and multiple anogenital lesions are common in men with Treponema pallidum PCR-positive primary syphilis without herpes simplex virus coinfection: A cross-sectional clinic-based study","volume":"92","author":"Towns","year":"2016","journal-title":"Sex Transm Infect"},{"key":"R7-20260626","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1586\/14787210.3.5.825","article-title":"Syphilis and HIV: A dangerous duo","volume":"3","author":"Karumudi","year":"2005","journal-title":"Expert Rev Anti Infect Ther"},{"key":"R8-20260626","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1186\/s12879-019-4269-8","article-title":"Early syphilis:Risk factors and clinical manifestations focusing on HIV-positive patients","volume":"19","author":"Arando","year":"2019","journal-title":"BMC Infect Dis"},{"key":"R9-20260626","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/OLQ.0b013e3181bf5a98","article-title":"Etiology of genital ulcer disease. A prospective study of 278 cases seen in an STD clinic in Paris","volume":"37","author":"Hope-Rapp","year":"2010","journal-title":"Sex Transm Dis"}],"container-title":["Indian Journal of Sexually Transmitted Diseases and AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijstd.ijstd_167_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:30:01Z","timestamp":1786735801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijstd.ijstd_167_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijstd.ijstd_167_25","relation":{},"ISSN":["2589-0557","2589-0565"],"issn-type":[{"value":"2589-0557","type":"print"},{"value":"2589-0565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-08-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}