患者男,25岁。3月前有不洁性接触史。全身多处起皮疹2月余。临床表现为掌跖红斑,阴茎、阴囊处花环状肉芽肿样斑块,肛周扁平湿疣,腹股沟簇集性褐色丘疹,玫瑰疹等,尿道口可见黄色浆液性分泌物。实验室检查:皮损血清渗出液暗视野显微镜下可见梅毒螺旋体,RPR、TPPA(+),NG(-),CT和UU(+)。予阿奇霉素治疗非淋有效,治疗梅毒无效,改用苄星青霉素后皮损消退,RPR滴度下降。 Male patient, 25 years old. 3 months ago, history of dirty contact. Rash over the body more than two months. Clinical manifestations of palmoplantar erythema, penis, scrotal calanoid granulomatous plaques, perianal flat condyloma, groin clustered brown papules, rose rubella, visible urethral serous discharge. Laboratory examination: Treponema pallidum, RPR, TPPA (+), NG (-), CT, and UU (+) are visible under darkfield microscopy in the leucoma of the lesions. Azithromycin treatment of non-Lin effective treatment of syphilis invalid use of benzathine penicillin skin lesions subsided, RPR titer decreased.