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Primary Syphilis

This painless, indurated ulcer is typical of the chancre of primary syphilis. This patient also had a positive RPR in a titer of 1:32.

Chlamydia trachomatis, serovar L2b-a recently discovered microbe-was the cause of atypical lymphogranuloma venereum in this HIV-positive patient.

Go-For-The-Glory Quiz

Skills quiz: Chondrodermatitis nodularis helices; Keratoses; OSA; Parotid swelling and HIV; Limbal flush

Syphilis is often called the "great imitator." The slides that follow show syphilis in various guises-and various disorders that can mimic the cutaneous manifestations of the sexually transmitted infection.

Clostridium difficile infection is a serious, life-threatening nosocomial infection that can follow on the heels of broad-spectrum antibiotic use. It affects over 500,000 Americans annually, with 15,000 deaths. Infection recurs in 15% to 25% of those initially treated successfully; infection subsequently redevelops in 40% to 50% of those an initial recurrence.

Like other chronic inflammatory conditions, inflammatory bowel disease (IBD) has been revolutionized by the advent of biologic agents that fundamentally alter the inappropriate inflammatory response. The most potent of these are the biologic agents, infliximab, adalimumab, certolizumab pegol, and natalizumab. They also have the most dangerous side-effect profile.

A 38-year-old man presented with a 2-week history of mental status changes and impaired memory. He also had a rash on both hands and feet that had been getting worse for the past few months.