painless lesions on the genitalia

A 39-year-old mechanic came into the clinic complaining of several painless lesions on his penis and scrotum that appeared gradually and had been sweeping for a week. He denies taking any medicine, has no relevant past medical history, and is HIV negative. However, He admits to having unprotected sexual intercourse with a number of women in the prior four months. His physical examination revealed bilateral inguinal lymphadenopathy and more than 43 moist, firm, pink papules on the scrotum and penile shaft, as shown in the image below. The rest of the examination was normal. A rapid HIV infection test was performed; the result was negative; thus, a biopsy was taken for further evaluation. Considering the patient’s history and physical examination findings,