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.