Rare presentation of lues maligna and nodular syphilis in an immunocompetent patient

Secondary syphilis can present in many ways; common presentations of secondary syphilis include a generalized papulosquamous or pitriasifrom generalized eruption that commonly affects the palms and soles.1 Recently, a rapid rise in the number of syphilis cases globally has been noted, with rare forms of syphilis potentially presenting more frequently.2,3 Lues maligna (LM) is a rare papulonodular or ulcerative subtype of secondary syphilis generally associated with immunosuppression; a recent literature review published in 2021 noted that out of 45 published cases, 33 (73%) were HIV positive.4 Here, we present a rare case of a 34-year-old ethnically Arabic, immunocompetent male patient with LM with clinical, dermoscopic, serologic, and histopathologic findings.