Primary syphilis (lues primaria). Lues primaria presenting as an ulcer at the site of inoculum. This foreskin ulcer was relatively painless; it has sharp borders, and it is clean, without debris. If pressed, syphilitic spirochetes can be seen in microscopy using the dark field technique. In this case serological tests for syphilis were positive, but they may be negative in other cases. In suspected cases the tests should be repeated later. The possibility of other venereal diseases should also be remembered (gonorrhoea, chlamydia, HIV).