This is malignant syphilis, a rare form of secondary syphilis
- Syphilis rashes normally are maculopapular and starts from extremities. They may ulcerate eventually (as in this case).
Mnemonic for syphilis manifestation according to stage: C CAR TAP
- Primary (first 3 months): chancre
- Secondary (first 6 months): Condyloma lata, aloprecia, rash
- Tertiary (many years later): tabes dorsalis, argyll-robertson pupil, paresis (also syphilitic gummas, neurosyphilis may appear in tertiary syphilis)
Jiu-Hong Li, Hao Guo, Xing-Hua Gao, Hong-Duo Chen. Multiple skin ulcers from malignant syphilis. The Lancet, 2015