Condyloma Lata

The phenomenon known as the Prozone Effect occurs when the antibody titer of a patient with syphilis is so high that it overwhelms the ability of the RPR test to detect it.  It particularly occurs during pregnancy, with HIV infection and in rip-roaring cases of secondary syphilis.  

Condyloma lata are notably different from condyloma acuminata by being softer- MUCH softer- than condyloma acuminata, and by being usually broader and flatter than condyloma acuminata.  They are commonly patches as well as papules.  Their corresponding lesions on the mucous membranes are called, surprisingly, mucous patches.  They have the same spongy appearance as their perigenital counterparts.  

The whole reason for asking this question is to call attention to the soft nature of the condyloma lata, and to call attention to the Prozone Effect.

As an addendum, consider ordering an  FTA-ABS for those patients who you think might be false-negative RPRs.