Corresponding author: Kiyozumi Suzuki, kiyozumi.suzuki.med@gmail.com
DOI: 10.31662/jmaj.2023-0068
Received: May 1, 2023
Accepted: June 8, 2023
Advance Publication: September 13, 2023
Key words: secondary syphilis, Treponema pallidum, skin rash, palms and soles
A 57-year-old heterosexual male with diabetes was admitted to our hospital for glycemic control. During his physical examination, a nonpruritic rash was found on his trunk and extremities, including palms and soles (Figure 1). He reported a previous genital lesion and a similar rash that resolved spontaneously. Six months earlier, he had unprotected sex with a casual female partner. He was diagnosed with secondary syphilis based on being positive for rapid plasma reagin and Treponema pallidum hemagglutination. The test for human immunodeficiency virus was negative. He was treated with amoxicillin, which resulted in the healing of the rash.
The rash of secondary syphilis is typically diffuse, nonpruritic, symmetric, and maculopapular on the trunk and extremities; however, the rash is nonspecific and difficult to distinguish from other skin rashes (1), (2). Nonetheless, the rash involving the palms and soles is a crucial clue to the diagnosis of secondary syphilis (2). Considering the rapid increase in the number of syphilis cases in Japan (3), (4), physicians should conduct a thorough dermatological assessment, including the examination of the palms and soles, to avoid overlooking the diagnosis of syphilis.
None
Shun Takei: Writing - Original draft, Methodology
Kiyozumi Suzuki: Methodology, Writing - review and editing
Hiromasa Otsuka: Methodology, Writing - review and editing
Seishi Watanabe: Methodology, Writing - review and editing
All authors critically reviewed the manuscript.
Consent was obtained from the patient for the use of images for publication.
In this study, IRB approval was not required.
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Takahashi T, Arima Y, Yamagishi T, et al. Rapid increase in reports of syphilis associated with men who have sex with women and women who have sex with men, Japan, 2012 to 2016. Sex Transm Dis. 2018;45(3):139-43.
Yoshikura H. Changing demography of genital chlamydia, gonorrhea, genital herpes, condyloma, and syphilis infections in Japan. Jpn J Infect Dis. 2021;74(1):35-41.
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