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Current Issue

Spring/Summer 2025, Vol. 32 No. 1

Hong Kong J. Dermatol. Venereol. (2025) 32, 86


Dermato-venereological Quiz

Dermato-Venereological Quiz

HF Cheng 鄭學輝

A 31-year-old man presented with symptoms of acute urethritis for 3 days after an unprotected sex with a male commercial sex worker. Gram stain microscopy on urethral mucosal fluid showed features highly suggestive of gonorrhoea. The patient showed you a few skin lesions at the end of the consultation. He wasn't exactly sure how long the skin lesions were, as they were not itchy or painful. But he recalled that his skin was completely normal a month ago.

Dermatologic examination showed a healthy young man who was afebrile. There were a few variably sized, sharply-delimited, pinkish to red scaly skin plaques on his trunk (Figure 1). The face, neck, palms and soles together with mucosa were unremarkable.

His past health was good. There was no recent drug intake, contact or travel history.

Figure 1 The eruption as seen over the right anterior chest wall of the gentleman, viewed at a distance.

Questions

  1. What are the clinical differential diagnoses?
  2. What would be the investigation of choice?
  3. If a skin biopsy is done, what would you expect to see under the microscope?
  4. How would you manage this patient?