History:

Young male presented with widespread eruption of asymptomatic, exophytic slightly red papules/plaques involving trunk, extremities and face (shown here). Because fo the florid nature of the acute eruption, and a history of unprotected intercourse, syphilis was suspected. RPR was positive 1:256. This type of secondary syphilis is common in HIV-coinfected individuals and, indeed, he was found to be HIV+.