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Secondary syphilis and HIV.

Shagun Dhaliwal1, Mahir Patel, Alan Menter

  • 1Texas A&M Health Science Center College of Medicine, Bryan, Texas (Dhaliwal), and the Division of Dermatology, Department of Internal Medicine, Baylor University Medical Center at Dallas (Patel, Menter).

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Syphilis, known as the "great mimic," presents varied symptoms. This case highlights a human immunodeficiency virus (HIV)-positive man diagnosed with secondary syphilis manifesting as a persistent papular rash.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Immunology

Background:

  • Syphilis is characterized by diverse clinical presentations, earning it the name 'great mimic'.
  • Dermatological manifestations, particularly papular eruptions on palms, soles, and mucous membranes, are hallmarks of secondary syphilis.
  • Co-infection with human immunodeficiency virus (HIV) can alter the typical presentation of syphilis.

Purpose of the Study:

  • To report a case of secondary syphilis in an HIV-positive individual.
  • To illustrate how HIV infection can influence syphilis presentation.
  • To emphasize the importance of considering syphilis in patients with atypical dermatological findings.

Main Methods:

  • Case report of a 41-year-old male patient.
  • Clinical presentation review focusing on dermatological findings.
  • Diagnostic confirmation of secondary syphilis.

Main Results:

  • The patient presented with a papular rash lasting several months.
  • The diagnosis of secondary syphilis was confirmed.
  • The presentation was consistent with altered syphilis manifestations in an HIV-positive individual.

Conclusions:

  • Secondary syphilis can present atypically in HIV-positive patients.
  • The 'great mimic' nature of syphilis requires vigilance, especially in immunocompromised individuals.
  • Early diagnosis and treatment are crucial for managing syphilis and preventing complications.