Secondary syphilis with granulomatous inflammation in a returning traveler: A case report

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BACKGROUND: Syphilis poses substantial diagnostic complexity due to its diverse dermatologic and systemic manifestations, underscoring the importance of early identification to prevent progression and complications. CASE PRESENTATION: Herein, we present a clinical case of a 24-year-old female patient experiencing a three-week history of fever, arthralgia, and a generalized maculopapular rash. While the diagnosis of syphilis was confirmed by serological and molecular tests, histopathology revealed unusual granulomatous dermatitis. CONCLUSION: This report of atypical granulomatous secondary syphilis emphasizes the need to include secondary syphilis in the differential diagnosis of atypical cutaneous eruptions of return travelers and supports the incorporation of molecular techniques into diagnostic evaluation.