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A 62yo white male presented to same day clinic with an erythematous nodular rash. He was initially treated with antibiotics for a furunculosis, but the rash worsened and he was eventually found to have secondary syphilis. He is an MSM who had a prior history of syphilis, putting him at high risk for STI’s and HIV, and should have been undergoing annual screening. He was found to be HIV positive. The rates of STI’s and HIV are increasing in older Americans. Despite this, physicians do not regularly screen this population for unsafe sexual behavior. This case emphasizes the importance of taking a sexual history in older patients, assessing their risk for STI’s and HIV, and providing them with education about safe sex.

Figure1_Lesions_on_palm.JPG (1176 kB)
Figure 1 Lesions on palm

Figure2_Lesions_on_back.JPG (1181 kB)
Figure 2 Lesions on back

Figure3_Lesions_on_chest.JPG (1224 kB)
Figure 3 Lesions on chest