LAUSR

test turned out to be negative at 3 months after the treatment. Syphilis is a prevalent sexually transmitted disease caused by TP. Secondary syphilis is a notorious “Great Mimicker”, because its clinical features have a very extensive diversity. Physicians are increasingly challenged by unusual presentations from secondary syphilis. The most common cutaneous presentation for secondary syphilis is a generalized, non-pruritic, papulosquamous eruption varying from pink to violaceous or brown, with mucosal involvement. The presentation of palmoplantar lesions is a helpful diagnostic clue for secondary syphilis. Pustular lesions or impetigo-like lesions in secondary syphilis are less common. Immunocompromised patients infected by syphilis could have pustular lesions more commonly than immunocompetent individuals. Although our present patient had a negative result of HIV assay, his low Body Mass Index (16.46) suggested he was malnourished. Thus, the poor nutrition status could be another risk for syphilis patients to develop impetigo-like lesions. In summary, we reported a case with secondary syphilis in a malnourished patient with unusual impetigo-like lesions. It is worth testing for syphilis in patients with perplexing rashes, especially those that failed the standard therapy.