HI Acquired palmoplantar keratoderma in an immunocompromised patient: A case report

Syphilis, known for its capacity to mimic various diseases, has seen rising incidence, particularly in adolescents, men who have sex with men (MSM), and individuals with HIV. Palmoplantar keratoderma (PPK), a rare manifestation of secondary syphilis, poses diagnostic challenges due to its resemblance to other conditions. We report the case of a 42-year-old man living with HIV presenting with acquired PPK, characterized by hyperkeratotic plaques on the palms and soles, alongside syphilitic roseola. Histopathology confirmed psoriasiform dermatitis with spirochetes. The patient received weekly intramuscular benzathine penicillin G, leading to significant clinical improvement without relapse. This case underscores the importance of recognizing atypical infectious presentations in individuals living with HIV and highlights the need for careful differential diagnosis in acquired PPK cases.