Sexually transmitted diseases (STDs) remain a major public health concern in the 21st century. Cases of chlamydia, gonorrhea, primary and secondary syphilis, and congenital syphilis increased in 2018.1 Overall, although HIV diagnoses decreased from 2010 through 2017 by 11%, some groups still experienced increases, such as Latino/Hispanic men who have sex with men.2
According to the Centers for Disease Control and Prevention (CDC), all providers have a role in managing STDs.3 While the majority of cases are diagnosed in primary care offices, dermatologists may still see and diagnose STDs in their patients because many diseases have cutaneous manifestations.
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Improving Patient Comfort and Sexual Health
Sexually Transmitted Infection: Cutaneous Manifestations
The CDC recently released the Recommendations for Providing Quality Sexuality Transmitted Diseases Clinical Services, which addresses best practices for screening, treating, and preventing STDs. Here are some recommendations dermatologists can implement in their practice3:
- Remember the 5 Ps: number and gender of partners; specific sex practices (oral, vaginal, and anal); protection; past history of STDs; and prevention of pregnancy.
- Physical examination of the skin, pharynx, lymph nodes, anogenital region, and neurologic system among patients with any STD-related symptoms.
- Educate patients on safe sex practices or refer for STD/HIV counseling.
- Discuss notification and care of the patient’s sex partner(s).
- For patients who are at risk of acquiring HIV, preexposure prophylaxis can be prescribed by the provider or through referral to primary care or another specialist.
For many STDs, early detection and treatment are important to prevent complications and further transmission.3 See the CDC for a complete list of screening tools and treatment guidelines.4
1. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018. https://www.cdc.gov/std/stats18/default.htm. Updated August 27, 2019. Accessed January 7, 2020.
2. Centers for Disease Control and Prevention. HIV in the United States and dependent areas. https://www.cdc.gov/hiv/statistics/overview/ataglance.html. Updated January 3, 2020. Accessed January 7, 2020.
3. Barrow RY, Ahmed F, Bolan GA, Workowski KA. Recommendations for providing quality sexually transmitted diseases clinical services, 2020. MMWR Recomm Rep. 2020;68(No. RR-5):1–20. doi:10.15585/mmwr.rr6805a1
4. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(No. RR-3):1-137