A 36 year-old human immunodeficiency virus (HIV)-positive African American man presented with painful lesions on the soles of his feet. He stated that he had been treated with several applications of permethrin for pruritic lesions on his trunk 5 months earlier. The lesions resolved, and 3 months later he discovered several lesions on his feet that were painful rather than pruritic. On physical examination, there were several hyperkeratotic plaques ranging from 1.5 to 2.5 cm in diameter on the soles of his feet (Figure 1). His palms were not involved. On debridement of the lesions, marked hyperkeratosis was noted. A shave biopsy specimen was obtained (Figure 2).
Marchell NL, Lupton J, Elgart ML. Painful Plaques on the Soles of an HIV-Positive Man. Arch Dermatol. 2002;138(7):973-978. doi:10.1001/archderm.138.7.973