The diverse presentation of secondary syphilis. Case reports

SUMMARY BACKGROUND AND OBJECTIVES: In the last half of 20 th century, the advent of penicillin and more attention to initiatives aimed at prevention of sexually transmitted diseases represent a major breakthrough in the fight against syphilis. However, the prevalence of syphilis in Brazil is still high and so it is an important public health problem. The main purpose of these reports is the presentation of the variety of clinical manifestations of secondary syphilis, including unusual presentations and aspects of its association with human immunodeficiency virus (HIV). CASE REPORTS: Presented and discussed four cases of secondary syphilis treated with penicillin G benzathine, each with the followings presentations: palmoplantar papules and disseminated lesions, syphilids elegant, early malignant syphilis and alopecia. Systemic symptoms when present are also discussed, as well as the relationship between co-infection with HIV and laboratory tests. CONCLUSION: The study reflects the polymorphism of the skin lesions of secondary syphilis enhancing the expression that the disease was “the great imitator” and highlights the need to re-familiarization with the various forms of secondary syphilis.