Given the patient’s history of syphilis, the self-report of unprotected
intercourse with potentially infected individuals, and the correlation between palmar rash and syphilis,
an additional RPR and TP-PA were drawn in the offi ce and a three-dose penicillin G benzathine (Bicillin L-A)
treatment for syphilis was initiated.
The last RPR was reactive at 1:64 indicating that he was experiencing his fourth documented case of syphilis.
The rash resolved before he completed the dermatology consult.