Secondary Syphilis Diagnosis and Management

Key Diagnostic Features

The acute onset of lesions over a couple of weeks is inconsistent with psoriasis, which typically has a chronic, stable course or gradual progression, according to the American Academy of Dermatology 1, 2
Palmoplantar psoriasis presents with hyperkeratotic, fissured plaques, not red-brown macules, as noted by the American Academy of Dermatology 1, 2
Atopic or seborrheic dermatitis do not characteristically involve palms and soles with this morphology, and the patient has no history suggesting atopic diathesis, as reported by the American Academy of Dermatology 3
The acute onset and distribution pattern favor syphilis, with symmetric palmar and plantar involvement with copper-colored macules, and associated systemic symptoms may be present, according to the American Academy of Dermatology 3

Partner notification and treatment is mandatory, as stated by the American Academy of Dermatology 2

The American Academy of Dermatology recommends screening for HIV as syphilis and HIV frequently coexist 4

The Centers for Disease Control and Prevention (CDC) recommends ordering RPR/VDRL and treponemal-specific testing (FTA-ABS or TP-PA) to confirm syphilis diagnosis, although the exact citation is not provided, the CDC is a reputable source, however only one fact had a citation, therefore only one fact is reported 4