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Diagnose on Sight: Palmar Rash


palmar rashCase: A 41 year old male with one week of non-pruritic palmar rash that started on his trunk and spread to his hands. He has no history of travel, fever, joint pains, or medication use. What is your diagnosis for this palmar rash? Click on the image for a larger view.

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Stuart Swadron, MD

Stuart Swadron, MD – Professor of Emergency Medicine, Keck School of Medicine of the University of Southern California (provided to ALiEM and recorded by Swadron, 2014)

Patton M E, Su J R, Nelson R, Weinstock H. Primary and Secondary Syphilis – United States, 2005-2013. Centers for Disease Control and Prevention. Published May 9, 2014.
STD Facts – Syphilis & MSM. Centers for Disease Control and Prevention.
Dylewski J, Duong M. The rash of secondary syphilis. CMAJ. 2007;176(1):33-35. [PubMed]
Nobay F, Promes SB. Chapter 144. Sexually Transmitted Diseases. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011.
Jeff Riddell, MD

Jeff Riddell, MD

ALiEM Assistant Editor
Diagnose on Sight series;
Medical Education Research Fellow
University of Washington / Harborview Medical Center
Jeff Riddell, MD

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