Lichenoid secondary syphilis

Argentina Case 1 A married, heterosexual, promiscuous, 29-year-old white man had experienced an asymptomatic eruption on the trunk and left palm for the last 3 months. After 2 months, the trunk involvement disappeared, but 2 weeks later lip and tongue lesions developed. No history of genital ulcer was found. The physical examination revealed asymptomatic, violaceous, erythematous, flat-topped papules in an annular pattern, 5–10 mm in size, on the left palm ( Fig. 1 ). Painful vesicular lesions surrounded by a red halo, with erosions on the labial mucosa and defined areas of depapillation on the posterior aspect of the tongue, were observed. The genitalia and soles were free of lesions. The clinical findings suggested lichen planus or secondary syphilis.

Figure 1 Open in figure viewer PowerPoint Flat-topped papules on the palm