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July 1992

An Erythematous Nodular Eruption

Author Affiliations

King's College Hospital, Denmark Hill, London, England

Arch Dermatol. 1992;128(7):981-982. doi:10.1001/archderm.1992.01680170113020

REPORT OF A CASE  A 40-year-old homosexual man was referred to the dermatology department because of a widespread eruption that had appeared 4 weeks before and that had spread rapidly. The lesions were not pruritic and he was otherwise well. He denied any sexual activity for 4 years.Examination showed several dark-purple, smooth surfaced, nontender, grouped nodules and plaques on the arm, wrists, and knees (Figs 1 and 2) and isolated papules on the shaft of the penis. The lesions ranged from 0.5 to 3 cm in diameter. No mucosal lesions or lymphadenopathy was seen. The rest of the examination showed normal findings.A skin biopsy specimen was obtained from one of the nodules (Fig 3).What is your diagnosis?

DIAGNOSIS:  Secondary syphilis.

HISTOPATHOLOGIC FINDINGS  The biopsy specimen showed a dense inflammatory infiltrate in the middermis and the upper dermis with several mononuclear cells

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