Isolated initial clavus-like rash: a rare presentation of secondary syphilis.

We report two cases of secondary syphilis with an isolated papule on the palm as the initial presentation. The clinical manifestations of secondary syphilis can be diverse, with a high rate of misdiagnosis and underdiagnosis. This article presents two patients with a purpose to alert clinicians not to forget the great imitator of syphilis for lesions of uncertain diagnosis.