Primary syphilis with multiple chancres and porphyria cutanea tarda in an HIV-infected patient.

A 51-year-old promiscuous heterosexual man with no history of venereal diseases or porphyria had a large genital chancre and deep erosions on the hands. The HIV serology was positive; the CD4 lymphocyte count was 187/mm3, but the patient did not fulfill the CDC criteria for AIDS. Five months later he developed a clinical and biochemically typical porphyria cutanea tarda.