Summary

Introduction: Secondary syphilis, also known as the „great imitator”, represents a great challenge for the clinician because of the polymorphism of it’s clinical manifestations.

Case presentation: A 44-year -old male patient, affirmatively heterosexual, presented for asymptomatyc polymorphous skin and mucosal lesions. Clinical examination reveals pink macules in the abdominal region, brick-red annular plaques on the abdominal area, purple-red nodules with peripheral descuamation on the back, scaling erythematous lesions on the scrotum and penis, greasy scale covered erythematous lesions on the scalp, neck and face, purple-red lesion with central palling in the axilar region. We do not noted any pathological changes of the hair and nails. At the general examination, we found generalized painless microadenopathies and the patient complained for diffuse muscle pain. Serological reactions were highly, Treponema Pallidum Hemagglutination Assay (TPHA) 1:10240, Venereal disease research laboratory (VDRL) 1:32. Based on the clinical and laboratory findings, the diagnosis of secondary syphilis was established and treatment with Benzatin Penicilin was performed with remision of the lesions.

Conclusion: Atypical polymorphous skin eruptions impose serological testing for syphilis.