Syphilis: a review of the history, clinical features, and management

At the turn of the 20th century, the father of modern medicine,Sir William Osler, famously said, ‘The physician who knows syphilis knows medicine’. Syphilis refers to the sexually transmitted infection caused by the spirochete Treponema pallidum, which progresses through four distinct clinical stages, characterised by a unique set of cutaneous and/or extracutaneous manifestations. Since its entry into the scholarly literature as early as the 16th century, syphilis earned the reputation as a ‘great imitator’, due to its wide array of presentations. The extensive study of syphilis has been a topic of paramount interest to dermatologists worldwide. According to JE Lane in 1925, the field of dermatology was born from syphilology, a field necessitating intricate descriptions of the cutaneous lesions. In this review, we summarise the key features of syphilis, including its history, epidemiology, clinical presentation and management, with a special focus on the dermatological aspects of the disease.