A 25-year-old woman gravida 2, para 2, presented to the dermatology clinic for evaluation of a one-month history of a generalized asymptomatic rash. The patient had a history of poorly controlled Human Immunodeficiency Virus (HIV) infection with non-compliance to antiretroviral therapy, and prior chlamydia and gonorrhea infections. Additionally, she complained of a headache, which was unrelieved by aspirin, paracetamol, and caffeine. The patient denied vomiting, neck stiffness, tingling, numbness, or fatigue. Mucocutaneous examination revealed several ill-defined violaceous papules and plaques with peripheral scaling over her face, trunk, and extremities, including her palms and soles. Additionally, there were multiple ill-defined healing erosions with peripheral serpiginous violaceous borders present in the buccal mucosa. The lesions over the palms and soles were well-demarcated with a coppery hue. Furthermore, there were well-defined violaceous papules over the labia majora. Severe tenderness was elicited by applying gentle pressure to the lesions on the back.

See the question at https://www.infectiousjournal.com/article/1097.

What is the diagnosis?

A) Subacute Cutaneous Lupus Erythematosus

B) Rocky Mountain Spotted Fever

C) Lichen Planus

D) Secondary Syphilis

The correct answer is D – Secondary Syphilis.