This REVIEW is concerned with syphilis maligna praecox, a rare form of secondary syphilis sometimes preceded by a phagedenic primary chancre. The more common course of syphilis1 occurs initially with the occurrence of a primary chancre, an eroded indurated moist papule, usually within four weeks (10 to 90 days) of infection. The absolute diagnosis is made by finding the organism. Treponema pallidum (a positive dark-field), in the lesion or satellite lymph nodes. A presumptive diagnosis is made by a history of exposure and a rapidly rising serological titer. If syphilis has not been treated (4.8 million units of procaine penicillin in two divided doses), then the second stage appears two to six months after the initial infection. The clinical features of secondary syphilis are diverse; systemic symptoms such as malaise, fever, and arthralgias are usually trivial. The cutaneous lesions may assume various forms: macular, papular (often annular in shape),
Cripps DJ, Curtis AC. Syphilis Maligna Praecox: Syphilis of the Great Epidemic? An Historical Review. Arch Intern Med. 1967;119(4):411–418. doi:10.1001/archinte.1967.00290220161016
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