%0 Journal Article
%T Dermatologically challenging syphilis presentation
%A Alan R Katz
%A Alan Y Komeya
%A Douglas W Johnson
%A Juval E Tomas
%A Kozue Kobayashi
%A Thomas S Namiki
%J International Journal of STD & AIDS
%@ 1758-1052
%D 2019
%R 10.1177/0956462418817636
%X An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as molluscum contagiosum. Over a period of eight weeks, prior to dermatologic consultation, the papules enlarged, ulcerated, and healed. New plaque and patch formation on the penis and scrotum led to a differential diagnosis of inverse psoriasis vs. syphilis. Histological examination of a shave biopsy specimen revealed numerous Treponema pallidum organisms and repeat syphilis serological test results confirmed a syphilis diagnosis. Lesions responded to treatment with benzathine penicillin. One must keep a high index of suspicion for syphilis in light of its diverse presentation and increasing incidence
%K Syphilis
%K chancre
%K dermatology diagnosis
%U https://journals.sagepub.com/doi/full/10.1177/0956462418817636