Secondary syphilis presenting as annular lichenoid plaques on the scrotum.
BACKGROUND
Secondary syphilis can have protean clinical manifestations and can present with unusual lesions, which may go unrecognized.


METHODS
We report two cases of secondary syphilis with annular lichenoid plaques on the scrotum associated with generalized lymphadenopathy, fever, and malaise.


CONCLUSIONS
The serology revealed a reactive Venereal Disease Research Laboratory test and a positive Treponema pallidum hemagglutination assay. The human immunodeficiency virus (HIV) serology was nonreactive. The lesions cleared with a single dose of benzathine penicillin, 2.4 million units, given intramuscularly. The presentations of syphilis, often described as "the great imitator," can be varied and atypical. Increased clinical vigilance and awareness of the varied modes of presentation are needed to prevent missing this highly treatable, potentially serious condition.
Narang
Tarun
T
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
De
Dipankar
D
Dogra
Sunil
S
Kanwar
Amrinder Jit
AJ
Saikia
Uma Nahar
UN
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010401:Penicillin G Benzathine / Q000627:therapeutic use; D012611:Scrotum; D013591:Syphilis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy
D010401:Penicillin G Benzathine