You are correct. Serology confirmed infectious secondary syphilis. Other unusual presentations of syphilis may include palmar rash, arthralgia, and lymphadenopathy. Secondary syphilis sx resolve spontaneously, but untreated pts risk developing cardiac and neurological complications of tertiary syphilis. Consider syphilis even in the absence of typical risk factors. This pt was treated w/ IM benzathine PCN at the sexual health clinic.

BMJ 2019;364:l328