Article Text

Download PDFPDF
Painful rash with hoarseness: an atypical presentation of syphilis
  1. Courtney L Hanlon1,2,
  2. Artin Galoosian1,
  3. Saima Ali1,3 and
  4. Randall S Edson1
  1. 1 Department of Medicine, California Pacific Medical Center, San Francisco, California, USA
  2. 2 Department of Internal Medicine, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
  3. 3 Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
  1. Correspondence to Courtney L Hanlon,{at}


Syphilis is a sexually transmitted disease that can affect multiple organ systems, with central nervous system involvement at any stage. We present a 53-year-old woman with an unusual truncal rash with painful anogenital lesions, accompanied by patchy alopecia, oral lesions, photophobia and hoarseness. She was found to have positive serological tests for syphilis with cerebrospinal fluid findings suggestive of neurosyphilis. She underwent a 14-day course of intravenous penicillin G and exhibited successful resolution of painful anogenital lesions as well as marked improvement in dermatological, oropharyngeal, laryngeal, and neurological symptoms.

  • ear, nose and throat/otolaryngology
  • infectious diseases
  • syphilis
  • dermatology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Patient consent for publication Obtained.

  • Contributors CLH is a fourth year medical student at the Dartmouth Geisel School of Medicine; she was on the patient’s care team during her hospitalisation and assisted in the planning and reporting of this case. AG is a resident physician at California Pacific Medical Center and was directly involved in the care of this patient as well as guidance in the acquisition of data for this case. AG is also the patient’s primary care physician. SA was the senior resident physician at California Pacific Medical Center at the time of this patient’s presentation, and was directly responsible for this patient’s care. She has since completed her residency and is now a hepatology fellow at Rutgers New Jersey Medical School. RSE is a hospitalist and residency program director at California Pacific Medical Center and was directly involved in the conception and design of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.