A 45-year-old man infected with the human immunodeficiency virus (HIV) presented with a 3-month history of violaceous oval macules and papules on the trunk and extremities (Figure 1) as well as multiple lichenoid papules over the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints and elbows (Figure 2). Brownish-red scaly patches were observed on the palms. His most recent CD4 cell count was 158 cells/mL, and his viral load was 175 102 copies/mL.
Kingston AA, Vujevich J, Shapiro M, Hivnor CM, Jukic DM, Junkins-Hopkins JM, Jih DM, Kostman JR, James WD. Seronegative Secondary Syphilis in 2 Patients Coinfected With Human Immunodeficiency Virus. Arch Dermatol. 2005;141(4):431-433. doi:10.1001/archderm.141.4.431