Atypical palmoplantar lesion in relapsed advanced latent syphilis with HIV co-infection

Abstract

Syphilis is a systemic infection caused by Treponema pallidum subspecies pallidum, which has a major and various manifestations on the skin (the great imitator). Its prevalence is frequently associated with Human Immunodeficiency Virus (HIV) prevalence. Atypical and aggressive presentation of syphilis is more commonly found in persons with syphilis and co-infection of HIV. We report a case of a 30-year-old male with erythematous plaques and desquamation on his palms and soles with neither pain nor pruritus, and also Beau’s line on the hand and toe nails. HIV infection was detected. The diagnosis of the patient was relapse late latent syphilis with HIV co-infection. The diagnosis of syphilis was established based on clinical and serological testing. The clinical manifestations of syphilis in immunosuppressed patients are often atypical. In order to treat, the patient was prescribed with doxycycline 100 mg two times a day for a month and showed clinical improvement after three weeks course of medication. Serologic testing interpretation and treatment do not differ between syphilis patients with and without HIV co-infection.