Sexually transmitted diseases can come in different forms, with an assortment of symptoms and, not to mention, a great deal of anxiety.
Different diseases display different symptoms, ranging in severity and extensiveness. Several DoctorxDentist readers asked questions about syphilis, including how to know if the diagnosis is conclusive and what kinds of treatments can be found in Singapore.
Here's a compilation of some answers from Singapore doctors with experience in treating this condition.
What is syphilis and how is it transmitted?
One of the most commonly contracted forms of sexually transmitted diseases, syphilis is generally spread through sexual intercourse including vaginal, anal and oral sex.
They cause sores called chancres on the genitals. These sores are usually painless, but they can be spread through infection.
Routine health checkups can identify syphilis
According to dermatologist Dr Tan Wei Sheng, syphilis is commonly detected during routine health checkups or some pre-employment tests.
Results are based on a combination of at least two positive blood tests, in order to make sure that the conclusion is precise.
Latent syphilis may present no symptoms
Initially, if someone is diagnosed with latent syphilis, symptoms may not be experienced. This means that if the person does not go for a checkup and receive a diagnosis, the disease may not be detected by him or her for long periods of time.
Either way, the diagnosis process is similar to normal syphilis.
Early stages of syphilis have more visible symptoms
Secondary stage syphilis sores (lesions) on the palms of the hand. These are referred to as "palmar lesions".
Since earlier stages of syphilis are more infectious and aggressive, patients may experience the formation of painless ulcers around their genital area, followed by a general body rash affecting the palms and soles of the feet.
In this case, swabs can be taken to help confirm the diagnosis. Confirmation is reached through two different types of blood tests.
Some patients may test positive for syphilis for their entire lives
In some instances, syphilis tests carried out on patients can remain positive across the rest of their lives even after treatment.
This can, of course, make interpretation of the tests difficult. So doctors will need a detailed history in order to establish whether the infection is new or whether it is one that has been treated.
Specific penicillin is used to treat syphilis
An effective and relatively common treatment used in Singapore is made up of a special penicillin injection which can be found at the DSC, dermatology clinics, or sexual health centres in Singapore.
Early stages only require a single jab, whereas late stages may require three jabs (once every week).
Some tests may detect other chronic diseases instead
If patients opt for RPR (Rapid Plasma Reagin), a type of rapid diagnostic test, positive results may indicate other conditions besides syphilis. These include chronic liver disease, pregnancy, lupus, or other infections.
However, RPR and TPPA tests used together have better accuracy
With both the RPR and TPPA (Treponema pallidum particle agglutination assay) tests, if both tests produce positive results, it is most likely that the patient has syphilis.
Being diagnosed with syphilis can be devastating. But knowledge is power; do your research on treatments available in Singapore that can manage symptoms and lead you to better management of the disease. And do inform your sexual partner if you suspect that you have any sexually transmitted disease, so he or she can get tested too.
Make sure you seek treatment quickly once syphilis is suspected.
1. David Brown. Diagnosis and management of syphilis. Jul 2003.
2. French, Patrick. “Syphilis” BMJ (Clinical research ed.) vol. 334,7585. Jan 2007.
3. Ficarra, Giuseppe and Roman Carlos. “Syphilis: the renaissance of an old disease with oral implications” Head and neck pathology vol. 3,3. Sep 2009.