Among the commonest lesions of secondary syphilis are moist papules, which are usually found about the genitals and anus. When fused in plaques they form the familiar condylomata lata of secondary syphilis, and it has long been known that their growth is favored by the moisture, heat and friction of opposing surfaces.
One of the less common places for such lesions, and one that may be overlooked and thus cause an error in diagnosis, is between the toes, especially if the patient has an associated dermatophytosis. In our experience it is not uncommon to see patients who have attended clinics and have been treated for dermatophytosis when there was an associated syphilitic process present. The moist, boggy skin with macerated opposing surfaces that characterizes fungous infections between the toes offers an ideal place for the localization of Spirochaeta pallida and the formation of moist papules, which in some cases present
THOMAS EW, BLUEFARB SM. EARLY SYPHILITIC LESIONS MISTAKEN FOR DERMATOPHYTOSIS. Arch Derm Syphilol. 1940;42(1):11–14. doi:https://doi.org/10.1001/archderm.1940.01490130015002
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