In his session, Professor Henry De Vries, a leading dermatologist from Amsterdam, will shed light on the atypical manifestations of syphilis. A particularly aggressive form known as ‘malignant syphilis’ or ‘Lues maligna’ can affect not only the skin but also the brain and heart. Doctors should pay particular attention to patients living with HIV, as they are more likely to develop this form, which requires more extensive diagnostic investigation.
In the field of STI prevention, Prof. De Vries highlights the effectiveness of Doxypep in preventing syphilis and chlamydia, but warns against its widespread use due to increasing antibiotic resistance. The introduction of Lenacapafir, an injectable preparation for HIV prevention lasting up to six months, is innovative, although its high price is a limiting factor.
Effective vaccines against hepatitis B and HPV exist, but there is still a need in the field of gonorrhoea and other STIs. There is considerable interest in the ongoing investigation of the use of meningococcal vaccination against gonorrhoea in the UK, which has so far shown a protective effect of around 30%.
Two promising new drugs, zoliflodacin and gepotidacin, are about to be launched for the treatment of resistant pathogens, particularly in gonorrhoea-induced urethritis. These drugs are alternatives to existing therapies and show non-inferior efficacy.
A critical issue for dermatological practice is the assessment of neurosyphilis, especially in cases involving the eyes and hearing. The lumbar puncture typically used for this purpose has low sensitivity, which is why these patients should be treated as if they had neurosyphilis, even without confirmation.