{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:40:08Z","timestamp":1756363208844,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,8,14]]},"abstract":"<jats:p>A previously healthy 24-year-old man presented with an erythematous, non-pruritic and painless papulonodular skin rash affecting the trunk, upper arms (excluding palms), neck, face, forehead and scalp. He had a penile ulcer for the past 2\u2005weeks, almost healed at the time of observation. The patient tested positive for syphilis and HIV-1; he claimed being negative for HIV 6\u2005months earlier. As the palms were not affected, we performed a skin biopsy for the differential diagnosis between secondary lues and acute HIV seroconversion reaction. Benzathine penicillin (2\u2005400\u2005000 units) was administrated and antiretroviral therapy started. Although the skin biopsy was compatible with secondary syphilis, there was no change in the skin rash 3\u2005weeks after the first penicillin administration. Another 2 doses of penicillin were given but 4\u2005weeks later the rash persisted. A second biopsy revealed a mucinous skin infiltration, compatible with nodular mucinosis.<\/jats:p>","DOI":"10.1136\/bcr-2015-210285","type":"journal-article","created":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T09:57:38Z","timestamp":1440583058000},"page":"bcr2015210285","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Nodular mucinosis misdiagnosed as non-responsive secondary syphilis"],"prefix":"10.1136","volume":"2015","author":[{"given":"Catarina","family":"Patr\u00edcio","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital de Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Campos","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital de Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Jo\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital de Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasco","family":"Serr\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital de Santo Ant\u00f3nio dos Capuchos, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,8,26]]},"reference":[{"key":"2025082722593816000_2015.aug26_1.bcr2015210285.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1995.tb02673.x"},{"key":"2025082722593816000_2015.aug26_1.bcr2015210285.2","unstructured":"Sarkany RPE , Breathnach SM , Morris AAM , et al . 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