The epidemic of sexually transmitted diseases (STDs) in Russia continues. In 1997, the notification rate of the disease was just above 270 cases per 100,000 population. In some regions, such as Tyva and Khakassia in Siberia, more than 1% of the population has syphilis (Russian Ministry on Health, unpublished observation, 1998).

During this epidemic, a significant change in the manifestations of the disease has occurred: The number of latent cases of syphilis decreased from 25% in 1989 to 15% of all cases in 1997. The number of early cases of syphilis is also changing.<sup>1 Tikhonova L., Borisenko K., Ward H. , y al. Epidemics of syphilis in the Russian Federation: Trends, origins and priorities for control Lancet 1997 ;  350 : 21

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The vast spread of syphilis is seen among every age group of the population from infants to the elderly; pregnant women; patients with severe somatic diseases, such as diabetes or cardiovascular diseases; and patients with chronic dermatologic disorders. Russia is one of the world leaders in alcohol consumption. All these factors may influence the characteristic and clinical features of syphilis.