It is generally recognized that there are three distinct diseases which are more or less characteristic of the negro race, namely, keloid, elephantiasis and uterine fibroid. It is not so well known that there is a form of cutaneous syphilis, the so-called annular syphilid, which is also strikingly characteristic of the negro. This is an early manifestation of the disease and a modification of the flat papular or discoid syphilid. The lesions apparently begin as flat papules which enlarge peripherally and clear up in the center, forming circular elevated rings. By the coalescence of several rings, various gyrate and festooned patches are produced.
The annular syphilid is not only much more frequent in the colored than in the white race, but when present is much more extensive. The eruption is seen most often on the face, but may also occur on the trunk and extremities, especially the back. It appears
HOWARD FOX. A CASE OF ANNULAR PAPULAR SYPHILIS IN A NEGRESS. JAMA. 1913;60(19):1420–1421. doi:10.1001/jama.1913.04340190014007