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Off-Center Fold
January 2010

Erythematous Erosive Patch on the Left Nipple—Diagnosis

Author Affiliations


Arch Dermatol. 2010;146(1):81-86. doi:10.1001/archdermatol.2009.335-b

At low power, the skin biopsy specimen showed hyperplasia in the epidermis and dense perivascular and periadnexal infiltrate in the dermis with a slightly nodular pattern. At high power, there was dense infiltration of inflammatory cells, including lymphocytes and plasma cells.

Laboratory tests revealed a positive reaction to venereal disease research laboratory (VDRL) slide testing. Further laboratory tests showed a positive reaction to assays for fluorescent treponemal antibody absorption (FTA-ABS), FTA-ABS IgM, and Treponema pallidum hemagglutination (TPHA). The VDRL titer was over 1:32. Immunohistochemical analysis with a polyclonal antibody, anti–T pallidum, was performed, and many spirochetes were found.

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