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March 1980

Diagnosis of Secondary Syphilis

Author Affiliations

San Francisco

Arch Dermatol. 1980;116(3):272. doi:10.1001/archderm.1980.01640270032004

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To the Editor.—  In a suspected case of secondary syphilis, it is desirable to diagnose the condition immediately so that treatment may be given, rather than waiting several days for a serology report. This is preferable to the unfortunately common practice of treating suspected cases before accurate diagnosis is made. The dark-field examination can be used to diagnose secondary syphilis quickly and accurately, even when only dry, scaly, sparse lesions are present. The following technique is one I have developed for this purpose.One or more suspicious lesions are chosen and anesthetized with 1% lidocaine without epinephrine. The lesions are then pinched with a hemostat, which results in almost immediate transudation of serous or serosanguinous fluid. This fluid is touched to a coverslip and examined in the usual manner.Fifteen patients with secondary syphilis I have examined in this manner were dark-field positive. Serologic samples are, of course, also drawn,

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