Physical examination of a patient yielded cutaneous findings suggestive of lymphoma or sarcoidosis. A roentgenogram of the chest revealed nodular infiltrates at the bases of both lungs, lending support for the diagnosis of sarcoidosis. On biopsy, skin lesions showed noncaseating granulomata. The correct diagnosis of syphilis was first suspected on the basis of a reactive Venereal Disease Research Laboratory test. Clinically, atypical forms of syphilis may be on the rise because of short-term antibiotic treatment given to patients during the incubation period of the disease.
Biro L, Hill AC, Kuflik EG. Secondary Syphilis With Unusual Clinical and Laboratory Findings. JAMA. 1968;206(4):889-891. doi:10.1001/jama.1968.03150040101027