Condylomata Lata
A 17-year-old girl presented to the dermatology and venereology clinic with a 1-month history of pruritic genital lesions. Three months before presentation, she had had unprotected sexual intercourse with multiple male partners. She had no history of sexually transmitted infections. On physical examination, her vital signs were normal. Multiple smooth, grayish-white papules and plaques were noted on the vulva and upper inner thighs. A Treponema pallidum particle agglutination assay was positive, and subsequent testing revealed an elevated rapid plasma reagin titer of 1:16. A diagnosis of condylomata lata of secondary syphilis was made. Condylomata lata are highly infectious skin lesions that typically develop in intertriginous regions or on mucus membranes. They may be confused with condylomata acuminata (genital warts) but typically have a smoother, moist appearance. Treatment with intramuscular penicillin G benzathine was initiated, and counseling on the importance of condom use was provided. Testing for other sexually transmitted infections, including human immunodeficiency virus infection, was negative. At the 1-month follow-up visit, the lesions had resolved, and the rapid plasma reagin titer was 1:8.
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