An unusual presentation of secondary syphilis in an 18-year-old man

ABSTRACT

INTRODUCTION: Secondary syphilis is a sexually transmitted infection characterized by localized or diffuse mucocutaneous lesions, often with generalized lymphadenopathy with laboratory evidence consistent with syphilis. Condolyma latum is one of the many forms of secondary syphilis and is noted to occur commonly on moist intertriginous areas of the body such as the axilla, web spaces of the toes, genital and perianal regions. CASE REPORT An 18 year-old man presented with a four-month history of few erythematous pruritic plaques on the penile shaft and multiple moist plaques involving the scalp, face, anterior neck, nape, axilla,anterior abdomen, upper and lower extremities, and scrotum. There are few erythematous scaly patches noted on the palms and soles. Serologic testing confirmed a diagnosis of syphilis and the patient tested negative for human immunodeficiency virus infection. The patient was given a single dose of intramuscular benzathine penicillin G 2.4 million units, with noted flattening of all lesions upon follow-up three months later. CONCLUSION: Condylomata lata, although most commonly found on moist intriginous areas of the axilla, web spaces of the toes, genital and perianal regions, can also involve less commonly affected areas such as the scalp, face, anterior abdomen, and the extremities. A high index of suspicion therefore is warranted to differentiate it from other cutaneous diseases and to prevent progression of the disease by initiating appropriate antibacterial therapy.