A 26-year-old man with a 6-year history of human immunodeficiency virus (HIV) presented to our Emergency Department with a diffuse non-pruritic rash. The rash appeared 2 weeks before his presentation; it first appeared on the legs, then the arms, followed by the chest, while sparing the face. He denied fevers, chills, headache, or gastrointestinal complaints. He also denied any history of travel or tick bite. No other contributory symptoms were found.
He admitted to a history of having had sex with men. Previous records, from 2 years prior, showed the patient was rapid plasma reagin (RPR) negative, and viral load was 127,366. On physical examination, the rash was noted to be a collection of erythematous macules and papules, covering all extremities, palms, soles, and genital region, and sparingthe face (Figure 1, Figure 2). The lesions were small, dry, round, erythematous macules that were also metric, and without exudate. The patient also exhibited diffuse lymphadenopathy. No hair lesions, alterations, or alopecia were noted. No mucosal lesions were noted. No other contributory physical findings were noted.
Lesions on the Sole of the Left Foot. Note the erythematous 4-7-mm macules on the sole, with fine scaling, extending to the arch of the foot and legextending proximally.
J Emerg Med. 2008;35(1):83-85. © 2008 Elsevier Science, Inc.
Cite this: Secondary Syphilis - Medscape - Jul 01, 2008.