Images in Clinical Medicine
Secondary Syphilis
N Engl J Med 1997; 337:321July 31, 1997
- Article
Figure 1 A 32-year-old man presented with a five-day history of nonpruritic, copper-colored palmoplantar macules and papules (Panels A and B), several of which were crossed by creases. The patient did not have a history of syphilis but had noted a painless chancre-like papule on his glans penis that had cleared spontaneously two months earlier. On physical examination, mucous patches, condylomata lata, and truncal lesions were absent, but a rapid plasma reagin test was positive at a titer of 1:512. The patient was treated with intramuscular penicillin G benzathine (2.4 million units), with full resolution of the palmoplantar papulosquamous eruption within one week. A rapid plasma reagin test performed five months later was positive at a titer of 1:2. A test for antibodies to the human immunodeficiency virus was negative.
Fern A. Wirth, M.D.
University of Maryland School of Medicine, Baltimore, MD 21201
