Dermoscopic clues in the skin lesions of secondary syphilis

Abstract

Secondary syphilis may have a varied clinical presentation and might pose a diagnostic difficulty when a typical history is absent. We describe the dermoscopic clues of the skin lesions at different stages of the disease which could culminate to a proper diagnosis.

Keywords: Biett’s sign; dermatoscopy; dermoscopy; infectious disease; syphilis.

Figure 1

A and B, Clinically, erythematous maculopapular rash can be seen over left forearm and right palm. Dermoscopy (polarized dermoscopy, original magnification × 20) of lesions over forearm, C and palm, D showing scaling within the skin furrows (white arrowheads) and central darker area fading toward the periphery with an ill‐defined border. Orange color of the lesion can be noted in the lesion over palm. E, Dermoscopy (polarized dermoscopy, original magnification ×20) of a psoriatic lesion over palm from a different patient showing larger scales, pinkish color and dotted vessels

Figure 2

A and B, Clinically, lesions with increased scaling and decreased erythema can be seen over bilateral forearms and palms, respectively, on the 5th day of initial presentation. Peripheral scaling can be clearly noted in the lesions over palms. C and D, Dermoscopy (polarized dermoscopy, original magnification × 20) of lesions over forearm during the visit showing peripheral scaling with a relatively clear central area. E, Clearance of scaling seen on palms on the 14th day of treatment