Syphilis: an old enemy still lurks.

Purpose: To review the problem of increasing cases of syphilis as a communicable disease and to review different presentations of syphilis and to discuss treatment guidelines.

Data Sources: Extensive review of worldwide scientific literature on the epidemiology, diagnosis, and treatment of syphilis.

Conclusions: Syphilis is an infectious sexually transmitted disease, which may have devastating consequences. Previously declining rates have led to complacency in prevention and diagnosis. Primary prevention includes education regarding safer sexual practices. Secondary prevention includes early identification via screening and treatment.

Implications For Practice: Syphilis is a contagious disease that has devastating consequences if not diagnosed and treated. Providers should keep ever vigilant in its identification. Specifically, it should be considered when evaluating all symptom-less dermatological lesions.