Rebecca Galante, MD
Galante R. Secondary syphilis. Consultant. 2012;52(9):645.
The appearance of a rash on his hands and feet prompted this man to seek medical evaluation. For the past year, he had been in a monogamous relationship with a male sex partner. During the 6-week period after the relationship ended, the patient noted the gradual onset of body aches, early satiety, malaise, and this rash on the palms of his hands (A) and the soles of his feet (B).
A rapid plasma reagin (RPR) test that had been performed 10 months earlier was negative. On repeated testing, the RPR titer was positive at 1:64, and a fluorescent treponemal antibody absorption (FTA-ABS) test was positive.
Because the patient had a penicillin allergy, he was treated with oral azithromycin. Within 48 hours of treatment, the rash started to resolve.
The patient found out that his former partner had other sexual relationships that he was not aware of. An HIV test was negative.