Syphilis, the great mimicker, is back.

BACKGROUND: Syphilis, which had been uncommon in Australian cities until recently, has re-emerged as a major sexually transmissible infection among men who have sex with men. OBJECTIVE: In this article we review the clinical features and management of syphilis infection, together with measures clinicians can undertake to enhance syphilis control. DISCUSSION: Syphilis should be considered in men who have sex with men who present with a rash or anogenital lesions. Men who have sex with men should be serologically screened for syphilis on a regular basis, including those who are HIV infected. Management of syphilis infected individuals should include adequate treatment and efforts to maximise the testing and treatment of sexual partners. Early detection and treatment of syphilis will help control the current syphilis epidemic in Australia among men who have sex with men.