Case Report

Papulonecrotic Eruption in a 44-Year-Old-Man

Authors: Michael A. Jacobson, MD, Ross B. Pollack, MD, John C. Maize, Jr, MD

Abstract

A patient is described who presented with the acute onset of widely distributed necrotic papules mimicking pityriasis lichenoides et varioliformis acuta. A skin biopsy revealed granulomatous inflammation and spirochetes were demonstrated. Serologic testing confirmed infection with the Treponema pallidum. Syphilis is still a great imitator and its persistence as an infectious disease is reviewed.


Key Points


* More than 80% of patients with secondary syphilis have cutaneous findings.


* Syphilis is a great imitator of many cutaneous and systemic diseases.


* Secondary syphilis may demonstrate granulomatous inflammation in skin biopsy specimens.

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References