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Painless penile chancre in primary syphilis due toTreponema pallidum: The ulcer is due to the endarteritis obliterans beneath

the epidermis, which decreases blood flow causing ischemic necrosis of the overlying skin. Since nerves are around vessels, they are alsodestroyed, hence the painless features of the ulcer.
http://mynotes4usmle.tumblr.com/post/47588961058/usmlepathslides-painless-penile-chancre-in

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