Grouped follicular secondary syphilis: Case report and review of literature

Secondary syphilis typically presents with macular, maculopapular or papular lesions, sometimes with systemic symptoms; however, there are some less common cutaneous presentations which can result in several differential diagnoses. We report the case of a 25‐year‐old man with the recent onset of a symmetric eruption of grouped follicular papules, for which syphilis was not originally considered. Histopathology revealed non‐caseating granulomas with a lichenoid infiltrate. Subsequent spirochete immunostaining was positive, and further physical examination revealed moth‐eaten alopecia, confirming the diagnosis of secondary syphilis.