The Biett Collarette as an Important Dermascopic Finding of Secondary Syphilis

Syphilis is a sexually transmitted infection that presents with cutaneous manifestations during the disease course. The lesions seen in secondary syphilis can manifest differently in each individual and resemble lesions seen in other conditions; thus, making the diagnosis difficult in some circumstances. The lesions in secondary syphilis can be distinguished by a peripheral scale surrounding each lesion, known as a Biett Collarette. This unique finding can be visualized better via dermoscopy. Given this historically hard to diagnose condition, looking for the Biett Collarette can aid providers in diagnosing secondary syphilis. We encourage providers to look for this finding when presented with a vague maculopapular rash with secondary syphilis on the differential.