REPORT OF A CASE
A 27-year-old woman presented for evaluation of symptomless skin lesions that had appeared 2 months earlier on her abdomen, back, and face and had progressively grown. She felt otherwise healthy.On examination, erythematous-violaceous, firm, 1-cm nodules were seen on the abdomen, dorsal surfaces of the upper limbs, scalp, and face. On the abdomen and arms the nodules coalesced into two plaques with a smooth surface, approximately 5 × 10 cm wide (Fig 1). The plaque in the nasolabial fold had a vegetating appearance (Fig 2).A biopsy specimen was taken from a nodule on the right arm. Microscopic examination showed a dense, poorly demarcated but predominantly perivascular infiltrate in the reticular dermis (Fig 3) composed of lymphocytes, epithelioid histiocytic cells, and numerous plasma cells (Fig 4).What is your diagnosis?
Tertiary (tubercular) syphilis.
The serologic tests for syphilis showed
Ghigliotti G, Ciaccio M. A Young Woman With Nodules on Her Face and Trunk. Arch Dermatol. 1989;125(4):551-552. doi:10.1001/archderm.1989.01670160099020