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Nov 2012

Scaly Pruritic Plaques in an HIV-Positive Patient—Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD;

Arch Dermatol. 2012;148(11):1318. doi:10.1001/archderm.148.11.1318-c

Histopathologic analysis (Figure 2) demonstrated an acanthotic and spongiotic epidermis with overlying parakeratosis and clusters of neutrophils. A dense lichenoid lymphoplasmocytic infiltrate was present, extending into the superficial subcutaneous tissue. Treponema pallidum immunostaining highlighted abundant spirochete organisms (Figure 3). The patient was treated with intramuscular penicillin G benzathine, 2.4 million U, as a single dose and was started on antiretroviral therapy. He noticed clearing of his lesions with postinflammatory hyperpigmentation after therapy.

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