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August 1954


AMA Arch Derm Syphilol. 1954;70(2):255-258. doi:10.1001/archderm.1954.01540200115015

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Late Secondary Syphilis; Early Manifestations Probably Submerged by a Single Small Dose Injection of Penicillin. Presented by Dr. Thomas Butterworth and Dr. John E. German, Reading, Pa.

K. N., a white youth, aged 20, presented comparatively few copper-colored, brownish, or violaceous papules on the forehead, nose, trunk, penis, scrotum, palms, and soles. The skin about the anus and in the third interspace of the right foot was white and sodden. There was diffuse scaling of the scalp with no loss of hair.

On Oct. 26, 1953, the patient developed bilateral inguinal adenopathy. The nodes are said to have been discrete, firm, and slightly tender. He was given 400,000 units of S. R. penicillin (each cubic centimeter with aqueous diluent contains 300,000 units crystalline procaine penicillin G). On Oct. 27, 1953, he had headache, chills, and fever (Herxheimer reaction?). On Jan. 29, 1954, the cutaneous manifestations appeared.

The patient's preemployment physical

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