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Article
October 1989

Psoriatic Patient Presenting With Perioral Herpetiform Lesions

Author Affiliations

207 Woodruff Memorial Bldg Department of Dermatology Emory University School of Medicine Atlanta, GA 30322

Arch Dermatol. 1989;125(10):1440-1441. doi:10.1001/archderm.1989.01670220138032
Abstract

To the Editor.—  Disseminated histoplasmosis is increasingly recognized in patients with acquired immunodeficiency syndrome (AIDS). We describe a patient with longstanding psoriasis who presented to our clinic with unusual-appearing herpetiform lesions that, after biopsy, showed cutaneous histoplasmosis. A subsequent test for the presence of AIDS proved to be positive. The patient repeatedly denied any risk factors.

Report of a Case.—  The patient was a 38-year-old white man with a 42-month history of widespread psoriasis and severe psoriatic arthritis. The severity of the joint involvement had resulted in the patient being confined to a wheelchair. Methotrexate had been employed by his rheumatologist (total received dose of 2205 mg). He presented to our dermatology clinic with complaints of malaise, fever, and odynophagia for 3 weeks, along with a 2-day history of a mucosal and perioral eruption. Examination revealed multiple partly grouped vesicles and pustules in the perioral area (Fig 1), along with

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