Syphilis is a serious health and social problem. Early detection of syphilis is essential to prevent serious complications. It is important to draw the attention of physicians of various specialties to the polymorphism of syphilis manifestations, especially in the secondary period, when the clinical picture can mimic various diseases and create difficulties for differential diagnosis. The article contains a short literature review of recent years with a description of the clinical picture of atypical syphilis course. We present a case of secondary syphilis without a primary clinical stage with a single manifestation in the form of flat condylomas in the perianal region. These manifestations were considered at entry medical examination by physicians of several specialties to be anogenital papular warts and Buschke-Lowenstein tumor. This was indicated by the nature of rash in the form of brown papules with a bluish tint, merging with each other, deep fissures on the surface, soreness. Syphilis was diagnosed by a laboratory examination. On the 20th day, clinical manifestations of the disease against the background of specific therapy regressed.