A 22-year-old homosexual man presented to a family medicine clinic with a 3- to 4-month history of a blanching, erythematous eruption involving 80% of his arms and trunk, and progressively painful, well-defined, scaling papules and plaques on his palms and the plantar surfaces of his feet. He also had marked lymphadenopathy in the submandibular region and complained of a sore throat and malaise. He was initially referred to an otolaryngologist, who performed a fine-needle aspiration of 4 lymph nodes. The patient was also referred to a dermatologist, who performed a skin biopsy and diagnostic testing.
The most likely diagnosis is
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Psoriasis
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Pityriasis rosea
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Sarcoidosis
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Secondary syphilis
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Drug eruption
Answer on page 410
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