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Article
April 1989

A Young Woman With Nodules on Her Face and Trunk

Author Affiliations

University of Genoa, Italy

Arch Dermatol. 1989;125(4):551-552. doi:10.1001/archderm.1989.01670160099020
Abstract

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?

DIAGNOSIS:  Tertiary (tubercular) syphilis.

LABORATORY EVALUATION  The serologic tests for syphilis showed

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