To the Editor.—
"Dose-related seroreversal in syphilis" by Durst et al1 suggests that 6 million units of benzathine penicillin G will cause seroreversal in patients with secondary syphilis more rapidly than will the smaller standard dose of 2.4 million units. In response to a letter by Kaufman and Kraus,2 who took issue with this conclusion, Allyn3 responded by emphasizing the desirability of rapid seroreversal following successful treatment of early syphilis. This would indeed be wonderful. We would be spared the usually difficult task of differentiating between relapse and reinfection, on the one hand, and biologic cure on the other, that is, determining whether a seroreactive patient requires more treatment.However, there is ample evidence that this is not possible. Evan Thomas, the grand old man of syphilology stated in his book,4 "The rate at which patients become seronegative after successful rapid treatment of early syphilis does
Schamberg IL. Seroreversal After Treatment of Secondary Syphilis. Arch Dermatol. 1976;112(5):729–730. doi:10.1001/archderm.1976.01630290071019
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