Early syphilis presenting as anal fissure: a case report

Syphilis is a chronic, systemic and infectious sexually transmitted disease. It is one of the great imitators in medicine affecting most of the organs in the body. It can present to any practitioner mimicking any medical or surgical disorder. We present a case of early syphilis which initially presented to surgeon as anal fissure and just before surgery; he was found to have a widespread skin rash, suggestive of secondary syphilis. On inquiry, he admitted to homosexual practice for the last 4-5 years. Diagnosis was confirmed on serology and was treated accordingly. Skin rash as well as anal symptoms disappeared within two weeks of treatment. He was referred to psychiatrist for behaviour therapy and was advised regular follow up