Malignant syphilis is considered a rare disease, more commonly affecting individuals with poor immunity. We report a case of acquired immune deficiency syndrome (AIDS) with repeated crusted ulcerations. Our report shows the typical skin lesions of malignant syphilis and a reinfection with the same rashes. A 22-year-old homosexual male was admitted to hospital for fever and ulcerations with overlying brown–black rupioid crusts. Then he was confirmed human immunodeficiency virus infection. Malignant syphilis was diagnosed by positive markers and biopsy pathology. After application of benzathine penicillin for 3 weeks, the symptoms improved and rapid plasma regain (RPR) decreased from 1:64 to 1:4 in 8 months. But the patient appeared with rashes that was accurately the same with rashes before 13 months later, and RPR rose to 1:128, which was likely to be reinfection after frequent sexual activity. And he responded well to doxycycline treatment. Although the clinical manifestations of malignant syphilis are severe, the response to the therapy of penicillin and doxycycline are excellent, even with repeated infection.

中文翻译：

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一名爱滋病患者反复出现多处皮肤结痂溃疡

恶性梅毒被认为是一种罕见疾病，更常见于免疫力低下的个体。我们报告一例反复结痂溃疡的获得性免疫缺陷综合征 (AIDS)。我们的报告显示了恶性梅毒的典型皮肤损伤和相同皮疹的再感染。一名 22 岁的同性恋男性因发烧和溃疡并伴有棕黑色的红褐色痂皮而入院。随后他被确诊为人类免疫缺陷病毒感染。恶性梅毒通过阳性标志物和活检病理学诊断。应用苄星青霉素3周后，症状改善，血浆快速恢复（RPR）在8个月内从1:64降至1:4。但患者出现的皮疹与13个月前的皮疹完全相同，RPR升至1:128，这很可能是频繁性活动后再次感染。他对强力霉素治疗反应良好。恶性梅毒的临床表现虽然严重，但对青霉素和多西环素治疗反应良好，即使反复感染。