Syphilis in an HIV infected patient misdiagnosed as leprosy

A 42-year-old man with uveitis and a widespread cutaneous eruption, histopa thologically characterized by dermal granulomatous infiltrates with perineu rial invasion, was incorrectly diagnosed and treated as having borderline l eprosy. Further studies demonstrated secondary syphilis and human immunodef iciency virus (HIV) infection. Standard penicillin therapy resolved his cut aneous and ocular lesions. Reports on clinical and pathological findings of active syphilis in HIV infected patients are scarce but this case and isol ated previous case reports suggest that granulomatous infiltrates might be a common feature in secondary syphilis with short evolution in HIV infected patients.