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A man with suspected but untreated secondary syphilis had nonscarring alopecia, photodistributed facial eruption, oral ulcers, leukopenia, and low C3 level; biopsy of a palmar lesion showed dyskeratotic keratinocytes, basal vacuolar alteration, papillary dermal edema, and perivascular and periappendageal infiltrates of lymphocytes and histiocytes. What is the diagnosis and what would you do next?
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Zheng et al. (2026) studied this question.
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