Fig. 1

Clinicopathological findings. a. Skin lesions before treatment. These 1–5-cm erythematous lesions were scattered on the trunk. Lesions larger than the size of a walnut were ulcerated and crusty. Palmer and planter lesions were also present. b. Nodular infiltration of the cells from the epidermis to the upper subcutaneous. c. Epidermotropism of atypical lymphoid cells. d. In the dermis, there is severe inflammation around the venules. Atypical lymphocytes, multinucleated leukocytes, and epithelioid histiocytes are present, but sparse plasma cells. e. Immunohistochemical staining for CD8. Lymphocytes were exclusively immunoreactive for CD8. Atypical lymphocytes with nuclear twisting and indentation are also present (arrows). f. In the bone marrow clot, a number of CD8+ lymphocytes are infiltrating, as indicated by immunohistochemistry. g. Atypical lymphocytes and small lymphocytes are seen in the bone marrow smear, suggestive of non-neoplastic cells (arrowheads). h. Treponema pallidum is mainly distributed in the dermis, especially in the perivascular space with histiocytes. Immunohistochemical staining for Treponema pallidum