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[Clinical Picture] Multiple skin ulcers from malignant syphilis

A 38-year-old man presented to our department in April, 2014, with a 1 month history of multiple painful skin ulcers (figure) on his face, trunk, and extremities. The eruptions had started as papular and nodular lesions and progressed to pustules and painful ulcers within 2 weeks. He had been diagnosed with pyoderma gangrenosum at his local hospital and treated with methylprednisolone. After 1 week, the lesions had worsened and he had developed fever. He reported having had sex with four women during the past year and denied ever having sex with men.