Lues maligna in an immunocompetent male

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Carly Dunn
Danielle S. Applebaum


lues maligna, immunocompetent, syphilis, secondary syphilis


Lues maligna (malignant syphilis) is an aggressive, rapidly developing, rare variant of secondary syphilis and is characterized by flu-like prodromal symptoms followed by an eruption of irregularly scattered erythematous papules and pustules that quickly progress into well-defined necrotic ulcers. Atypical presentations of syphilis, such as lues maligna, occur more commonly in HIV-positive and immunocompromised individuals. We present a rarer case of an immunocompetent patient with lues maligna. As syphilis is a great mimicker and is easily treatable, dermatologists should consider this diagnosis in a patient presenting with lesions consistent with pityriasis lichenoides et varioliformis acuta, drug eruption, disseminated herpes or zoster infection, cutaneous T-cell lymphoma, and ulcerating vasculitis.


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