Routine Serologic Testing for Syphilis in a Community Medical Practice.

A retrospective review of 8,100 serologic tests for syphilis ordered during a 42-month period yielded positive rapid plasma reagin test results in 127 patients (1.6 percent) and a positive fluorescent treponemal antibody absorption reaction in 91 patients (1.1 percent). Of the 36 cases of biologic false-positive reactions, most were in prenatal patients. Forty-six cases of syphilis were previously undiagnosed but antibiotic therapy was given in only 26 of the patients. Some 24 percent of syphilitic patients were not treated because the positive serologic findings were overlooked. Cerebrospinal fluid determinations were analyzed and cost-effectiveness of finding a single case of previously undiagnosed syphilis was calculated. We found that routine serologic tests and cerebrospinal fluid studies for syphilis in asymptomatic patients had low rates of positivity in our community hospital and outpatient practice.

Papular dermatitis of pregnancy.

Papular dermatitis of pregnancy is a condition characterized by widespread intensely pruritic papules that show no particular anatomic predilection. These lesions may occur at any time during the pregnancy and may be associated with increased fetal wastage. The response to corticosteroids is prompt and gratifying to the patient and the physician. Therapeutic doses of prednisone have not been associated with increased fetal loss. The etiology of the condition is unknown and it may recur with subsequent pregnancies.