PMC5607913_01
(a) Skin manifestations of lues maligna on presentation and response to treatment at (b) 1 week and (c) 2 weeks.
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More lesions later developed on his back, legs, feet and testicles (see Figure 1).
Dense dermal plasma cell infiltrates with an overlying purulent serum crust and reactive hyperplastic epidermal changes.
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Microscopic examination showed dermal lymphoplasmacytic infiltrates with overlying cutaneous ulceration suggestive of syphilis (see Figure 2).