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A 3-year-old boy with atypical skin lesions was diagnosed with syphilis, probably acquired through close daily contact with his grandparents. The case highlights the critical need for syphilis testing in children with non-specific skin findings, particularly when familial exposure is suspected. Physicians should prioritise thorough assessment, including detailed enquiry into the child’s medical history, feeding practices, lifestyle and potential exposure to infection. Prompt screening of close contacts including family members and carers is essential in order to identify infection sources and prevent further transmission.Abbreviations: ANA: Antinuclear antibody; ESR: Erythrocyte sedimentation rate; RPR: Rapid plasma reagin; TPPA: T. pallidum particle agglutination
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Li et al. (2025) studied this question.
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