A 50-year-old male was referred to our hospital for further examination of non-cancerous, irregular-shaped gastric ulcers. Endoscopic examination showed friable and confluent ulcers covered with dirty white mucous in the gastric body and antrum, and pyloric stenosis was observed with normal pliability. Several verrucous lesions resembling syphilitic eruptions were observed in the middle body. Although was not identified in gastric biopsy specimens, the patient was diagnosed with secondary syphilis based on positive serologic tests for syphilis, presence of generalized eruptions in the past month and typical endoscopic findings of gastric syphilis. After administration of ampicillin (1500 mg/day for one week) , gastric edema, erythema, ulceration and pyloric stenosis significantly improved upon examination four months later. Recently, the incidence of syphilis has been gradually increasing, and it is important to be able to recognize the typical endoscopic findings of gastric syphilis.
