Due to diverse clinical and histopathological presentations, diagnosis of s
econdary syphilis can occasionally prove challenging.(1) This is especially
true in the setting of human immunodeficiency virus (HIV) infection. Varia
ble clinical presentations of secondary syphilis in HIV disease may result
in an incorrect diagnosis and an inappropriate treatment regimen.(2-10) Sim
ilarly, the histology of secondary syphilitic lesions may show considerable
variation, depending on the clinical morphology of the eruption. We report
2 cases of secondary syphilis in HIV-1-infected patients with cutaneous le
sions of variable clinical presentation and an unusual lymphoid infiltrate
simulating mycosis fungoides.