[Diagnosis and therapy of syphilitic changes of the skin and mucous membrane in the head and neck].

Since the mid seventies the German Federal Board of Statistics has recorded a decrease in the incidence of the classical venereal diseases gonorrhoea and syphilis. This decrease is based only on a decline in the morbidity of gonorrhoea. Statistics on syphilis show an increase, from about 6000 to 8900 new cases each year, that is an increase of 48% between 1974 and 1978. Some cities such as Cologne, with a total of 401 new cases each year, show an increase, while numbers in rural regions remain unchanged or show a slight decline. Between 1978 and 1980 at the ENT and Dermatologic OPC of Cologne University many ulcers of uncertain aetiology in the head and neck region have been diagnosed as primary or secondary syphilis or as unusual presentations of this disease. In our Department a primary lesion of the head and neck was the presenting symptom in about 6% of all newly diagnosed cases. The differential diagnosis of early syphilitis lesions in the head and neck, the present position of serological diagnosis, and the current treatment of syphilis are illustrated by selected typical lesions.