title: A case of syphilitic anal condylomata lata mimicking malignancy.
abstract: BACKGROUND
  Condylata lata in secondary syphilis is well known presentation and needs to be considered in differential diagnosis of perianal lesions. In England between 2013 and 2014 the overall incidence of infectious syphilis increased by 33% and is mainly seen in men who have sex with men.
  
  
  METHODS
  We report the management of a 49-years-old Caucasian homosexual man with perianal lesions that were suspicious of malignancy. After biopsies, colonoscopy, staging with computed tomography, magnetic resonance imaging and syphilis serology anal cancer was excluded and a diagnosis of syphilis was confirmed. He was referred to the sexual health clinic for the appropriate investigations and treatment.
  
  
  CONCLUSIONS
  This case highlights the consideration of treatable infectious syphilis pathology. The main differential diagnosis of perianal growths to consider is condylomata acuminata (warts caused by human papillomavirus), anal cancer, syphilis, chancroid, haemorrhoids, tuberculosis and lymphogranuloma venereum. To differentiate a biopsy is needed for histopathological examination. A dense plasma cell infiltrate and numerous spirochetes visualised by immunostaining confirms condylomata lata.
  
  
  CONCLUSIONS
  In UK, it is important for colorectal surgeons to be aware of syphilitic condylomata lata and consider this when dealing with perianal lesions. It is advisable to refer patients suspected of or diagnosed with syphilis to sexual health clinics to help improve outcome. In sexual health clinics additional investigations and treatment are available in addition to partner notification and follow-up can be offered.
authors.affiliation: Virgin Care, Sexual Health Teesside, Lawson Street Health Centre, Lawson Street, Stockton TS18 1HU UK. Electronic address: drtayal@btinternet.com.
authors.forename: Sarup
authors.initials: S
authors.lastname: Tayal
authors.affiliation: Department of Colorectal surgery, University Hospital of North Tees, Hardwick, Stockton on Tees, TS19 8PE,UK. Electronic address: fadloshaban@gmail.com.
authors.forename: Fadlo
authors.initials: F
authors.lastname: Shaban
authors.affiliation: Department of Histopathology, University Hospital of North Tees, Hardwick, Stockton on Tees TS19 8PE, UK. Electronic address: Kaushik.Dasgupta@nth.nhs.uk.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Dasgupta
authors.affiliation: Department of Colorectal surgery, University Hospital of North Tees, Hardwick, Stockton on Tees, TS19 8PE, UK. Electronic address: Mohamed.Tabaqchali@nth.nhs.uk.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Tabaqchali
keywords: Biopsy; Condylomata lata; Malignancy; Syphilis