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October 1998

Generalized Exanthem With Palmoplantar Involvement and Genital Ulcerations

Arch Dermatol. 1998;134(10):1279-1284. doi:

The exanthem and systemic symptoms resolved in 7 days. The lesions on the penis persisted for several days more and subsided slowly thereafter. The biopsy specimen showed discrete perivascular lymphohistiocytic infiltrates in the superficial dermis.

Results of the following new laboratory studies were normal: complete blood cell count, erythrocyte sedimentation rate, serum protein electrophoresis, blood chemistry analysis, and urinalysis. Flow cytometry of the lymphocytic T and B cells showed an inversion of the CD4/CD8 ratio (0.78), with an absolute CD4 cell count of 0.51×109/L. Five weeks after appearance of the genital lesions, the serologic parameters for syphilis (VDRL test, Treponema pallidum hemagglutination assay, and fluorescent treponemal antibody absorption test) continued to be negative. The serum had become positive for HIV-1 on the enzyme-linked immunosorbent assay, and on the Western blot assay thin bands were observed at the antigens P17, P24, GP41, and GP120. Three weeks later, the enzyme-linked immunosorbent assay and Western blot assay were repeated and the results of both were positive for HIV-1.

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