Syphilis and Monkeypox: An Issue in Sexual Medicine.

Dear Editor,

In 2022, monkeypox emerged as a new public health issue. This disease’s hallmarks are acute febrile illness and vesicular skin abnormalities[1]. Monkeypox has been prevalent in Africa for a very long time. Monkey across the world became the breeding ground of a new illness, including Europe and the Americas, in 2022. This disease is more prevalent in young male monkeys, and the majority of them are gay. Concurrent sexually transmitted disease among monkeypox case is possible, although there is minimal evidence on this topic. Several publications[2,3,4,5] have described the co-occurrence of HIV infection with monkeypox. The impairment of immunity in HIV cases is believed to cause significant clinical problems in monkeypox[2,3,4,5]. In addition to HIV, syphilis is a serious condition that can coexist with monkeypox in a patient. To the best of our knowledge, there are at least three cases of monkeypox and syphilis so far[2,3,5]. HIV infection has been reported concurrently in a patient[5]. All these three cases mentioned here had homosexual orientation and all were of male gender. No overt syphilitic symptoms were noted in any of them, but a reactive Venereal Disease Research Laboratory test was performed for the initial diagnosis of syphilis. Each patient presented with the typical symptoms of monkeypox, including fever and vesicular skin rash. All patients showed skin lesions in the genitalia. All cases experienced minor monkeypox symptoms, but subsequently recovered fully without any complications. According to this article, monkeypox and syphilis can co-occur. It will be helpful to conduct a serological investigation for syphilis and HIV in a monkeypox patient. On the other hand, monkeypox should be explored in a syphilis case that presents with an unusual skin lesion. The co-occurrence of monkeypox with syphilis, a disease that is exclusively sexually transmitted, may be a sign that the present outbreak of monkeypox may have been spread through sexual contact.