Abstract
The lowered index of suspicion on the part of clinicians, occasioned by the decrease in the number of cases of syphilis seen in practice in comparison with former times, has combined with a reduction in emphasis on the disease in medical school curricula to produce an increase in number of biopsies taken for diagnostic purposes from unrecognized early lesions of the disease. Also contributing to this problem are the diagnostic difficulties generated by the appearance of increasing numbers of exotic extragenital chancres, a phenomenon that is the natural consequence of the new sexual adventurousness among heterosexuals and the high incidence of the disease among male homosexuals noted in recent years. Biopsies are being submitted under cover of a wide variety of mistaken clinical diagnoses—psoriasis, lichen planus, pityriasis rosea, Kaposi's sarcoma, sarcoidosis, swimming pool granuloma, drug eruptions, leukemia cutis, mycosis fungoides, carcinoma, and many others. It is, therefore, incubent upon pathologists dealing with this material to be more aware than ever that their clinical colleagues are having difficulties along these lines.
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