This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. REPORT OF A CASE A 62-year-old woman presented to the Francis Scott Key Medical Center, Baltimore, with an asymptomatic eruption on the right shoulder of eight months' duration. There was no recent history of malaise, weight loss, fevers, or sweats. The patient had a positive tuberculin skin test result ten years previously, for which she was treated with isoniazid for one year. She reported being treated for "bad blood" in 1943, and received treatment for a rise in serum VDRL titers on three subsequent occasions (Table). Physical examination revealed a healthy-appearing woman with a 6.0 × 4.0-cm annular plaque composed of 0.5- to 1.0-cm discrete and confluent scaly erythematous and brown papules (Fig 1). The rapid plasma reagin was positive at a titer of 1:4096, while the VDRL result was positive at 1:256. The fluorescent treponemal antibody absorption test result was also positive. Her current sexual partner was rapid