Early syphilis

Given the transmission of Treponema pallidum during human sexual contact, syphilis now occurs in France only in sexually high-risk, disadvantaged populations. The English-language terminology of "early syphilis" has progressively replaced that of "primary" and "secondary" in French usage. Induration of the chancre and the papular nature of secondary skin rashes remain the best criteria for clinical diagnosis. Serological tests associate test specific for treponematoses (Treponema pallidum haemagglutination assay, TPHA) and a nonspecific screening test (Venereal diseases research laboratory, VDRL) to confirm clinically suspected disease. Routine use of long-acting penicillin (benzathine penicillin) is consistently effective. The continuing risk of active syphilis in a pregnant woman and the possibility of severe syphilis in HIV patients require vigilance.