title: [Syphilis in Montpellier, France, from 2002 to 2011: Survey in a free hospital screening centre for venereal disease and in the dermatology unit of a regional public hospital].
abstract: BACKGROUND
  In a context of resurgent syphilis in France since 2000, we conducted a retrospective study in two different centres in Montpellier, France: the dermatology department of a public hospital and an anonymous and free centre for provision of information, diagnosis and treatment of venereal diseases (CDAG-CIDDIST).
  
  
  METHODS
  All patients with syphilis seen from January 2002 to December 2011 were included with the collaboration of the National Health Institute (InVS) and the Bacteriology Department of the public hospital. Epidemiology, clinical presentation, serological data, and treatment and monitoring data for up to 2 years were recorded.
  
  
  RESULTS
  One hundred and seventy-five cases of syphilis were diagnosed: 154 at the CDAG and 21 at the dermatology unit. Ninety-six percent of cases concerned men with a median age of 36 years. Eighty-two percent of these cases involved men having sex with men (MSM). Forty-nine percent of cases were diagnosed in the secondary stage, 22% in the primary stage and 28% in the latent stage. The treatment administered in the majority of cases (73%) was benzathine-penicillin G. The numbers of patients showing incomplete follow-up were equal at both centres, with 31 patients (17.7%) failing to attend the follow-up visit. A decrease of at least 2 dilutions in VDRL score occurred in the year following treatment for 93 of 103 patients (90%). Patients managed at the dermatology department were older than their counterparts managed at the CDAG and exhibited more frequent cutaneous eruptions (58% vs. 3%, P<0.0001) but were less frequently bisexual. However, no significant differences were seen concerning sex and associated infections (hepatitis, gonococcal infection, HPV or herpes).
  
  
  CONCLUSIONS
  Syphilis is on the rise, especially in the MSM population. The epidemiological characteristics of our cohort were consistent with those of other Western European countries. Although the reasons for consultation differed between CDAG/CIDDIST and the dermatology department, the two centres are complementary. Benzathine-penicillin G was the most commonly used treatment, in accordance with the recommendations. Measures must be introduced to improve patient monitoring without compromising anonymity.
authors.affiliation: Département de dermatologie, CHU, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34000 Montpellier, France. Electronic address: florenceamelot@ymail.com.
authors.forename: F
authors.initials: F
authors.lastname: Amelot
authors.affiliation: CDAG/CIDDIST de Montpellier, département de dermatologie, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
authors.forename: E
authors.initials: E
authors.lastname: Picot
authors.affiliation: Département de l'information médicale, hôpital La-Colombière, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France.
authors.forename: A
authors.initials: A
authors.lastname: Meusy
authors.affiliation: Cellule de l'InVS en région languedoc-roussillon (CIRE), département coordination des alertes et des régions, institut de veille sanitaire, ARS LR - 28 Parc-Club du Millénaire, 1025, rue Henri-Becquerel, CS3000, 34067 Montpellier cedex 2, France.
authors.forename: C
authors.initials: C
authors.lastname: Rousseau
authors.affiliation: Laboratoire de bactériologie, hôpital Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Brun
authors.affiliation: Département de dermatologie, CHU, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34000 Montpellier, France.
authors.forename: B
authors.initials: B
authors.lastname: Guillot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003880:Dermatology; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006757:Hospital Units; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D013587:Syphilis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult
keywords: Epidemiology; Homosexualité; IST; MSM; Monitoring; Recrudescence; Resurgence; STI; Suivi; Syphilis; VDRL; VRDL; Épidémiologie