A case of secondary syphilis with framboesia syphilitica

A 51-year-old male had a sexual relation with a Brazilian female in Brazil 1 year ago. He has noted swelling of the cervical lymph nodes for 6 months. He visited our outpatient clinic 1 week after eruptions without subjective symptoms appeared on the palms, soles, genital region, oral cavity, and neck. He had two kinds of eruptions on the palms and soles, frambesia tropicalis-like eruptions and psoriasis-like eruptions. Frambesia tropicalis is an endemic treponematosis in Southeast Asia and Latin America. At the initial examination, the titers of TPLA and the slide precipication test were 19,800 T.U. and 64 times respectively. He was treated with amoxicillin(1,000mg/day), and the eruptions and lymph node swelling of the neck disappeared within 3 weeks. Although the eruptions on the palms and soles of this case resembled to those of frambesia tropicalis, we diagnosed this case as syphilis because of his onset age and the route of transmission.