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Hematoxylin-eosin–stained sections demonstrated a dense lichenoid infiltrate composed almost exclusively of plasma cells. A treponemal immunoperoxidase stain was positive for multiple spirochetal organisms within the epidermis and dermis. Serologic studies revealed a reactive serum rapid plasma reagin test, with a dilution of 1:512, and a positive treponemal antibody-absorption test result. The patient was informed of the diagnosis and refused to undergo testing for human immunodeficiency virus. She returned to the local Department of Health for treatment.
Noduloulcerative Lesions on the Trunk and Face—Diagnosis. Arch Dermatol. 2005;141(10):1311-1316. doi:10.1001/archderm.141.10.1311-h