Secondary syphilis with impetiginized lesions in untreated HIV infection

Abstract Syphilis may present with atypical cutaneous manifestations in immunodeficient patients and is easily misdiagnosed. We report a 39-year-old man with untreated HIV infection presenting with widespread non-pruritic lesions initially mistaken for impetigo contagiosa. Serology confirmed secondary syphilis with Lues maligna and palmoplantar hyperkeratosis ( Clavi syphilitici ). This case highlights the importance of considering syphilis in patients with atypical skin lesions and HIV-related immunodeficiency.