RT Journal
A1 Chiu H, Tsai T
T1 A crusted plaque on the right nipple
JF JAMA
JO JAMA
YR 2012
FD July 25
VO 308
IS 4
SP 403
OP 404
DO 10.1001/jama.2012.7538
UL http://dx.doi.org/10.1001/jama.2012.7538
AB 
A healthy 27-year-old heterosexual man presents with a crusted plaque on his right nipple. The lesion formed gradually over a week after a bite during sexual intercourse and has persisted for a month. The patient reports that over the following 2 to 3 weeks, no significant change in size or morphology of this lesion occurred. The lesion is not painful; neither fever nor associated systemic symptoms are noted. Now, 1 month later, the patient presents with a generalized asymptomatic skin eruption. Physical examination reveals generalized pink macules on the trunk and extremities (Figure 1A). A crusted, erythematous plaque is noted over the enlarged right nipple (Figure 1B).