A 45-year-old male presents with a rash consisting of small red bumps that are concentrated on his palms and soles. He also reports a history of a painless ulcer on his penis a few weeks ago. What might be the cause, and what are the next steps?
This patient's history and symptoms are suggestive of secondary syphilis. The classic painless ulcer (chancre) of primary syphilis often goes unnoticed and heals on its own, leading to the second stage, characterized by a rash that can involve the palms and soles. Blood tests for syphilis (RPR and confirmatory treponemal antibody test) should be ordered. If confirmed, the patient should be treated with penicillin and his sexual partners should be informed, tested, and treated if necessary.