A 58-year-old human immunodeficiency virus (HIV)-positive man presented with a 4-year history of an "irritated" and sometimes pruritic eruption on his groin. Examination revealed multiple scaly, erythematous, flat papules centrally coalescing into diffuse plaques involving the groin bilaterally (Figure 1). A potassium hydroxide preparation of a scale sample was negative for fungi. There was no inguinal lymphadenopathy. Laboratory tests revealed the following values: CD4 cell count, 187/µL; HIV RNA, 76 135 copies/mL. The patient did not respond to empirical treatment with low-, medium-, and high-potency topical corticosteroids, topical and oral antifungal agents, topical calcipotriene, selenium sulfide, benzoyl peroxide, or oral dicloxacillin. Skin biopsy specimens were obtained for histopathologic examination (Figure 2 and Figure 3).
Trauner MA, Ruben BS, Hatcher SL, Lawry MA. Groin Eruption in an HIV-Positive Man. Arch Dermatol. 2002;138(4):527-532. doi:10.1001/archderm.138.4.527