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A 27-Year-Old Man Comes to the Office Due to a 2-Week

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A 27-year-old man comes to the office due to a 2-week history of genital papules that are not painful or pruritic.  Over this period, he has also had fatigue and mild, generalized arthralgia but no urethral discharge or dysuria.  The patient had gonococcal urethritis 3 months ago, which was adequately treated, and tests for other sexually transmitted infections at that time were negative.  He is sexually active with several male and female partners and reports using condoms consistently after the episode of gonorrhea.  Temperature is 37.6 C (99.6 F) .  Physical examination shows a faint, diffuse maculopapular skin rash involving the trunk, extremities, palms, and soles.  There are several enlarged, nontender inguinal lymph nodes.  Genital examination reveals multiple elevated lesions on the scrotum and perineal region.  Histopathologic evaluation of these lesions would most likely reveal which of the following in this patient?


Definitions:

Cost Method

An accounting technique used to value an investment, where the investment is recorded at cost without recognizing periodic income but dividends received are recorded as income.

Goodwill Impairment

A decrease in the value of goodwill (intangible asset representing premium paid over fair value in a merger/acquisition) requiring adjustment to reflect its reduced value on the balance sheet.

Non-Controlling Interest

A minority share in a company's equity held by investors other than the parent company, reflecting ownership that does not control majority voting power.

CPA Canada Handbook

The comprehensive accounting and auditing standards guide adopted by the Chartered Professional Accountants of Canada, including the application of IFRS and other Canadian-specific regulations.

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