Typical lesions progress from red or gray macules or papules, to red or gray macules or papules with a central eschar or ulceration ... become hemorrhagic. The skin lesions are tender and painful.

in diameter, surrounded by a ring of flat, yellowish vesicles; there was erythema of the skin ... and the lesion was dry and flat. No adenopathy was found. On November 15, the eschar was incised ...