Although STD epidemiologic trends do vary from country to country, some recent trends remain more or less con- stant: high risk of syphilis in ethnic and disadvantaged minorities and in men who have sex with men, increased risk of STD in older men who utilize erectile dysfunction drugs routinely, and less-than-optimal condom use among youth. For diagnostic purposes, culture and lab-based testing is gradually being supplanted by immune-based, point-of-care rapid methods.
Syphilis remains a worldwide problem and can assume a wide variety of morphologies. Genital herpes may confer an increased lifelong risk of prostate cancer, and the most promising vaccine candidate has now been abandoned due to lack of efﬁ cacy. Largescale meta-analysis fails to prove that last trimester administration of acyclovir analogues reduces the risk of neonatal herpes in newborns with a mother known to be HSV-2 positive. While chancroid has disappeared from North America, it remains an important pathogen in Africa and Asia. LGV has enjoyed a resurgence, but now presents as proctitis or rectal ulcer, rather than as massive inguinal adenopathy.
Many governmental agencies recommend oral ivermectin (200 ug/kg × 2 doses) as forst line therapy for scabies. Dermoscopy has been shown to be an excellent method of sarcoptes demonstration in-vivo. Sinecatechins 15% oint- ment (a green tea derivative) has recently been approved as a ﬁ rst-line therapy for genital warts, making it the ﬁ rst prescription botanical drug which is FDA-approved in the United States.