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Off-Center Fold
October 2005

Noduloulcerative Lesions on the Trunk and Face—Diagnosis

Arch Dermatol. 2005;141(10):1311-1316. doi:10.1001/archderm.141.10.1311-h

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.