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Bejel, an endemic treponematosis caused by infection with Treponema pallidum subspecies endemicumhas not been reported in eastern Asia and the Pacific region. We report local spread of bejel among men who have sex with men in Japan. Spread was complicated by venereal syphilis.

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Treponema pallidum subspecies pallidum is the causative agent of venereal syphilis. Globally, syphilis remains a disease of heterosexual persons in low-to-middle-income countries.

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Epidemics test syphilis among men who have sex with men MSM occur in high-income settings 1. Other Sex species cause nonvenereal endemic treponematosis also called bejel, nonvenereal syphilis, or endemic syphilis, caused by T.

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These pathogens are morphologically and serologically indistinguishable 2. Clinically, there is little need to differentiate them.

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However, it is useful to differentiate them japan a emo cosplay porn health standpoint because their infection routes vary.

For this purpose, a nucleic acid test is useful 3.