Secondary syphilis as first presentation of HIV: a case report

The simultaneous occurrence of HIV and syphilis poses an increasing difficulty due to the dynamic interplay between these two diseases. In recent years, the worldwide prevalence of co-infection between these two major global health issues has increased, partly because each infection can facilitate the acquisition of the other. We report a case of a 36-year-old diabetic male presenting to our clinic with scattered erythematous papules and plaques with a collarette of scale on the palms, soles, and genital area. The patient had geographic tongue with linear white plaques and fissuring. Virology showed positive herpes simplex virus IgG antibodies for types 1 and 2, and skin biopsy demonstrated vacuolar interface dermatitis, acanthosis, lymphocyte exocytosis, and thinning of the rete ridges. Additionally, the HIV serology test was positive. A diagnosis of secondary syphilis on top of HIV was established. Given the significant consequences that the co-infection of syphilis and HIV has on impacted individuals, it is crucial to allocate more time, effort, and resources to investigate this condition.