DOI: 10.12890/2014_000161

The “Great Masquerader" Strikes Again: Secondary Syphilis Presentation with Erythema Multiforme (EM)-Like Lesions

Authors

  • Adi Brom Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Sheba Medical Center, Tel Hashomer, Ramat Gan
  • Idan Goren Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Sheba Medical Center, Tel Hashomer, Ramat Gan
  • Gad Segal Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Sheba Medical Center, Tel Hashomer, Ramat Gan

adi.brom@gmail.com

Keywords

Syphilis, erythema multiforme, fever and rash, fever of unknown origin

Abstract

Syphilis is a sexually transmitted disease known to present with highly variable manifestations, especially when left untreated. Patients who present to Internal Medicine Departments with fever and a rash are always a diagnostic challenge since mild viral diseases and life-threatening bacterial infections may manifest themselves similarly. In the following case presentation, we describe a patient with 1 month’s duration of fever and rash on the palms of the hand and soles of the feet, in the form of erythema multiforme (EM)-like lesions. His disease was diagnosed as secondary syphilis, once again justifying its name: the “great masquerader".

View the entire article

Downloads

References

  1. Read PJ, Donovan B. Clinical aspects of adult syphilis, Intern. Med. J. 2012;42:614–620.
  2. Sokumbi O, Wetter DA. Clinical features, diagnosis, and treatment of erythema multiforme: a review for the practicing dermatologist, Int. J. Dermatol. 2012;51:889–902.
  3. Lamoreux MR, Sternbach MR, Hsu WT. Erythema multiforme, Am. Fam. Physician 2006;74:1883–1888.
  4. Bhate C, Tajirian AL, Kapila R, Lambert WC, Schwartz RA. Secondary syphilis resembling erythema multiforme, Int. J. Dermatol. 2010;49:1321–1324.
  5. Wu CC, Tsai CN, Wong WR, Hong HS, Chuang YH. Early congenital syphilis and erythema multiforme-like bullous targetoid lesions in a 1-day-old newborn: detection of Treponema pallidum genomic DNA from the targetoid plaque using nested polymerase chain reaction, J. Am. Acad. Dermatol. 2006;55:S11–15.
  6. Mattei PL, Beachkofsky TM, Gilson RT, Wisco OJ. Syphilis: a reemerging infection, Am. Fam. Physician 2012;86:433–440.
  7. Brosh-Nissimov T, Mor Z, Avramovich E, Katchman E, Avidor B, Mor O et al. Syphilis outbreak among men who have sex with men, Tel Aviv, Israel, 2008–2009, Isr. Med. Assoc. J. 2012;14:152–156.
  8. Champenois K, Cousien A, Ndiaye B, Soukouna Y, Baclet V, AlcarazI et al. Risk factors for syphilis infection in men who have sex with men: results of a case-control study in Lille, France, Sex. Transm. Infect. 2013;89:128–132.
  9. Young MF, Sanowski RA, Manne RA. Syphilitic hepatitis, J. Clin. Gastroenterol. 1992;15:174.
  10. Kent ME, Romanelli F. Reexamining syphilis: an update on epidemiology, clinical manifestations, and management, Ann. Pharmacother. 2008;42:226–236.
  11. Tucker JD, Bu J, Brown LB, Yin YP, Chen XS, Cohen MS. Accelerating world wide syphilis screening through rapid testing: a systematic review, Lancet Infect. Dis. 2010;10:381–386.
  12. Cohen SE, Klausner JD, Engelman J, Philip S. Syphilis in the modern era: an update for physicians, Infect. Dis. Clin. North Am. 2013;27:705–722.

Published

2014-12-05

Issue

Vol. 1 No. 1 (2014)

How to Cite

1.
Brom A, Goren I, Segal G. The “Great Masquerader" Strikes Again: Secondary Syphilis Presentation with Erythema Multiforme (EM)-Like Lesions. EJCRIM [Internet]. 2014 Dec. 5 [cited 2026 Nov. 3];1(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/161

Most read articles by the same author(s)