It is a sexually transmitted disease, with transmission mode and very complex clinical variants. These can actually vary a lot from one person to another one, and it may happen that some symptoms are mistaken for those of other less serious diseases, delaying or leading to wrong care.
Syphilis is caused by a bacterium, Treponema pallidum, present in all the body secretions of infected persons, cutaneous lesions, and genital mucous membranes (including that of the mouth!).
Who has syphilis is more likely to be infected by the HIV virus because the skin lesions are the gateway to the virus. Often Syphilis and HIV are transmitted together.
Once healed there is no acquired immunity to subsequent infections: they can in fact be re-infected with an infinite number of times. Following the cure, the antibodies remain in the blood (which do not give protection) for many years, often for the whole life (serological scar).

How is it transmitted?

- With unprotected sex: they are at risk ALL types of relationship (oral, anal, vaginal).
- With the simple contact between the genitals.
- Through contact between genital and infected sexual toys.
- With exchange and use of contaminated sex toys.
- Through contact with genital skin lesions or mucous membranes caused by syphilis.
- Through contact with skin lesions that occur in the course of the disease.
- With the passage of bacteria from infected mother to child (congenital syphilis).

What are the symptoms?

Primary stage (from 2 to 8 weeks after infection):
- Appearance of a lump, that is a kind of painless pimple, at the place where the bacteria has penetrated (mouth, tongue, lips, pharynx, scrotum, penis, shaft of the penis, vagina, the region around the anus).
Subsequently, this nodule can turn into an ulcer called a chancre, which is not painful (unlike, for example, Herpes).
- The chancre may also appear on the hands or other body parts. Regional lymph nodes can get enlarged.

Secondary phase:
- Scattered spots on the skin of the body that can also involve hands and feet (skin rash)
- Swollen lymph nodes throughout the body (about 10% of cases)
- Possible fall of hair and nails
- Formation of circular patches with a red outline (mouth, palate, pharynx, larynx, penis, penis, vulva, the anal canal and rectum)
- Symptoms similar to the flu (grade fever), but can be mild or not be there at all
- Damage to various organs of the body (brain, heart, especially in HIV-infected subjects)

Tertiary stage (several years after the secondary stage):
- Extensive damage to internal organs, brain, nerves, eyes, heart, blood vessels, liver, bones and joints.

What if you do not care?

If left untreated, syphilis leads to serious damage to the nervous system, loss of ability to control muscle movements, paralysis, mental confusion, development of dementia, blindness, meningitis.

How is it diagnosed?

There are specific laboratory tests that can diagnose syphilis at any stage you are. If you have had unprotected sex or if you doubt that you contracted syphilis, ask your dermatologist or go to the nearest STD center.
If you result positive to syphilis, warn all the people with whom you have had sex in the last 6 months and advise them to make the necessary tests.

How is it treated?

Syphilis is treated with a specific family of antibiotics and, if treatment is carried out in the proper manner, it heals completely. It should be remembered that, once healed, one will not become immune to subsequent infections. This means that you can always get sick again with Syphilis.

How to prevent it?

- With the correct use of condoms during sexual intercourse.
- Avoiding unprotected sex with infected people.
- Using a condom from the beginning of sexual intercourse and not just at the very end.
- Using a condom to protect the objects used for the sexual practice.
- Using a condom from the beginning even during oral sex.
- By periodic tests if you have casual and frequent relationships.