title: The epidemiological and clinical presentation of syphilis in a venereal disease centre in Paris, France. A cohort study of 284 consecutive cases over the period 2000-2007.
abstract: Since 2000, the incidence of syphilis has risen in developed countries. An updated knowledge of syphilis features is the key for early diagnosis and treatment. Our objective was to appraise the clinical and epidemiological presentation of syphilis in Paris, France. A retrospective monocentric descriptive study of 284 consecutive syphilis cases was conducted in a venereal disease centre (Paris, France), over the period 2000-2007. Epidemiological, clinical and microbiological data were systematically collected, using standardized medical forms. Overall, 95% of the cases occurred in men (271/284), 83% in men having sex with men (MSM) (231/278), 58% in patients having more than 10 partners/year (138/240) and 19% in patients who never use a condom (49/253). At least one STD has been previously diagnosed in 79% (220/279) of the cases. In 50.5% of the cases (142/281), HIV serology was positive. Most patients had primary (82/279, 29%) or secondary (125/279, 45%) syphilis. The most frequent physical signs in primary and secondary syphilis were, respectively, a genital chancre (63/82, 77%) and a diffuse exanthema (108/125, 86%). Syphilis occurs chiefly in MSM, often in HIV-positive patients. Many patients never use condoms. These data will help provide the basis for the development of national information and screening campaigns.
authors.affiliation: Department of Dermatology and Venereology, Pavillon Tarnier, Hôpital Cochin, Université Paris 5-René Descartes, 89 rue d'Assas, 75006 Paris, France. farhidavid@yahoo.fr
authors.forename: David
authors.initials: D
authors.lastname: FARHI
authors.forename: Nada
authors.initials: N
authors.lastname: ZIZI
authors.forename: Philippe
authors.initials: P
authors.lastname: GRANGE
authors.forename: Nadjet
authors.initials: N
authors.lastname: BENHADDOU
authors.forename: Philippe
authors.initials: P
authors.lastname: GERHARDT
authors.forename: Marie-Françoise
authors.initials: MF
authors.lastname: AVRIL
authors.forename: Nicolas
authors.initials: N
authors.lastname: DUPIN
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013587:Syphilis / Q000150:complications / Q000453:epidemiology*; D013997:Time Factors