Secondary syphilis with impetiginized lesions in untreated HIV infection.

Syphilis may present with atypical cutaneous manifestations in immunodeficient patients and is easily misdiagnosed. We report a 39-year-old man with untreated HIV infection presenting with widespread non-pruritic lesions initially mistaken for impetigo contagiosa. Serology confirmed secondary syphilis with Lues maligna and palmoplantar hyperkeratosis (Clavi syphilitici). This case highlights the importance of considering syphilis in patients with atypical skin lesions and HIV-related immunodeficiency.