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Visual Treats in Dermatology
2022
:2;
23
doi:
10.25259/CSDM_22_2022

Palms and soles provide a window into STDs

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
Corresponding author: Arunachalam Narayanan, Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India. narayanan359@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Narayanan A, Mithin Kumar B. Palms and soles provide a window into STDs. CosmoDerma 2022;2:23.

A 22-year-old woman presented with multiple, asymptomatic, well-defined, pigmented macules on the palms and multiple, asymptomatic, discrete to coalescing, annular, lichenoid plaques on the soles [Figure 1] for 2 weeks. She had no history of genital ulcers or high-risk behavior. Due to the characteristic presentation, we screened her for venereal disease research laboratory test (positive, 1:64) and treponema pallidum hemagglutination (positive). We made a final diagnosis of secondary syphilis. The primary chancre may go undetected in a few patients, delaying their presentation to the venereologist. While dermatological manifestations of secondary syphilis are often non-specific, physicians should identify the hallmark features of secondary syphilis on the palms and soles. Patients with secondary syphilis require treatment with intramuscular benzathine penicillin of 2.4 million units. If untreated, such patients might progress to tertiary syphilis.[1]

Figure 1:: Multiple, asymptomatic, well-defined, pigmented macules on the palms and multiple, asymptomatic, discrete to coalescing, annular, lichenoid plaques on the soles.

Declaration of patients consent

Patient consent is not required as the patient’s identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Reference

  1. . Do not miss secondary syphilis: Examine the palms and soles. BMJ Case Rep. 2020;13:e237725.
    [CrossRef] [PubMed] [Google Scholar]

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