1. The Syphilis Rash That Came Back…
Recent Cases at the
Denver Metro Health Clinic

2. Case
19-yo MSM treated for secondary syphilis (RPR 1:128; FTA 4+) HIV: NR
Returns to clinic 4 weeks after treatment, complaining that his “syphilis rash has come back” – however now his rash:
Is now more prominent on his extremities and penis and is
More itchy, especially at night

9. Case On physical examination: Additional labs:
Multiple, partly excoriated papules on glans and shaft penis
Multiple discrete papules on elbows, wrists
Distinct burrow between index and middle finger of left hand
Additional labs:
RPR: reactive 1:8
HIV: NR

10. Case
Diagnosis: Scabies
Treatment: Permethrin 5%

11. Disclaimer Copyright all clinical photos:
Dr. Kees Rietmeijer, STD Control Program, Denver Public Health Department
Individual slides can be used for educational purposes with reference to source and/or inclusion of the DMHC logo