Secondary syphilis: a case mimicking erythema multiforme clinically and pathologically

Area of Science:

• Dermatology
• Infectious Diseases
• Pathology

Background:

• Secondary syphilis results from hematogenous spread of Treponema pallidum, typically 4-10 weeks post-exposure.
• Cutaneous involvement occurs in 70% of secondary syphilis cases, presenting diverse morphologies like maculopapular, vesiculobullous, and ulcerative lesions.
• The varied skin presentations of secondary syphilis can mimic numerous dermatological conditions, complicating accurate diagnosis.

Observation:

• This report details an unusual case of secondary syphilis.
• The patient's clinical and histological presentation closely mimicked erythema multiforme (EM).

Findings:

• The case demonstrates that secondary syphilis can present with features indistinguishable from erythema multiforme.
• Histological examination further supported the resemblance between the atypical syphilis presentation and EM.

Implications:

• Accurate and timely diagnosis of secondary syphilis is crucial to prevent complications and transmission.
• Clinicians should consider secondary syphilis in the differential diagnosis of erythema multiforme-like eruptions.
• This case underscores the importance of considering broad differential diagnoses in dermatology, especially for infections with protean manifestations.