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IN 1992, I was very lucky to have had the opportunity to go to
London on a study grant. I was enthralled by the picturesque
greeneries, vast edifices and massive castles rich in tradition,
with civilization strewn all over the place. I felt really happy and
lucky just to be there.
As weeks passed, the feeling of excitement
slowly turned into misery as I started to miss everything that was
Filipino. As I grow restless, I started to feel lonely and miss my
family. It was then that I decided to keep myself busy by enrolling
in two courses. Since there are many dermatological lessons related
to sexually transmitted disease, I took up an additional course on
sexually transmitted disease (STD) while taking up dermatology.
Thirsty for more, I took up an additional
two-year course on cosmetic surgery, ending up with 3
subspecialties, 13 years after I started my clinical practice.
I used this introduction because I am writing
about an interesting case of STD commonly known as syphilis.
Syphilis is rare in this country, but every once in a while, someone
comes to my clinic with this predicament.
Recently, I had a patient who has seen several
doctors already, some of whom have diagnosed him with eczema. The
first time I checked on the patient, I thought it was a textbook
case of syphilis. The red scaly rashes in the palms and feet, plus
the enlarge lymph nodes only point to syphilis. The rashes on the
area above the genital area is quite puzzling, you would think it
looked like a case of candidiasis (an opportunistic fungi). I
suggested that the patient should undergo more testing.
I asked the patient to purchase Benzathine Pen G
and required him to get the necessary injections as soon as
possible. He was so happy that he knows what his real condition was.
A few days after the injections, the rashes gradually disappeared.
Approximately 90 percent of all syphilis cases
are sexually transmitted. Exposure mainly occurs during oral, anal,
or vaginal intercourse. Transmission occurs through direct contact
with infectious exudates (discharge) from moist skin lesions or
mucus membranes of infected persons during sexual contact.
Transmission from touching children with congenital syphilis,
kissing, blood transfusion, sharing of needles and drug equipment,
accidental direct inoculation is extremely rare.
There are different stages in syphilis. The
first three stages are as follows: First, which is 3 days to 3
months prior to development of sores in the genitalia. Second, which
is 6 months before onset of clinical symptoms, and early latent,
which is one year before diagnosis. The estimated risk of
transmission per partner is 60 percent. The third stage is
considered infectious because of the 25-percent chance of relapse to
the secondary stage. The last stage is late latent syphilis and not
considered infectious.
Those with open sores, known as ulcerative
syphilis, promote HIV transmission by augmenting or increasing HIV
infectiousness and susceptibility. So beware, if you have one
sexually transmitted disease, chances are you have more.
For comments or suggestions, call 373-1558,
414-5880, (0917) 497-6261 or e-mail at gc_beltran@yahoo.com.
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