A skin rash with multiple pulmonary nodules.

A 37-year-old man presented with a 2-week history of fever and thoracic pain. On physical examination, he presented a nonpruritic skin rash (0.2–1-cm nontender pink papules) on the trunk (figure 1a), upper extremities, face and soles of the feet, which had developed about 2 months previously. He also had multiple palpable and painful lymph nodes. Additional history revealed that the patient had homosexual contact 3 months before the skin rash developed; a painless genital ulcer developed and then disappeared spontaneously.