title: The great imitator revisited: the spectrum of atypical cutaneous manifestations of secondary syphilis.
abstract: Syphilis is a well-known sexually transmitted infection infamous for its protean cutaneous manifestations. Over the last decade, the rate of infection in the USA has risen, particularly among human immunodeficiency virus (HIV)-infected individuals and certain ethnic groups. Although the primary chancre developing at the site of inoculation usually has typical and well-characterized features, cutaneous manifestations of secondary syphilis span a wide spectrum and mimic those of other dermatoses. This may be particularly evident in patients with HIV. Such deviations from the expected typical papulosquamous eruption may present a diagnostic challenge and delay diagnosis and therapy. Given the increasing incidence of syphilis among the immunosuppressed patient population, recognition of atypical cutaneous manifestations is critical for adequate management. We review a range of cutaneous manifestations of secondary syphilis and the skin diseases it may mimic.
authors.affiliation: Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Balagula
authors.forename: Peter L
authors.initials: PL
authors.lastname: Mattei
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Wisco
authors.forename: Gulsun
authors.initials: G
authors.lastname: Erdag
authors.forename: Anna L
authors.initials: AL
authors.lastname: Chien
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D013587:Syphilis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D013591:Syphilis, Cutaneous / Q000382:microbiology* / Q000473:pathology