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August 1995

Bacillary Angiomatosis Presenting as a Malleolar Ulcer

Author Affiliations

Barcelona, Spain

Department of Dermatology Hospital Universitary Germans Trias i Pujol Carretera del Canyet s/n 08916 Barcelona, Spain

Arch Dermatol. 1995;131(8):963-964. doi:10.1001/archderm.1995.01690200103026

Bacillary angiomatosis (BA) is a systemic infectious disease characterized by cutaneous and visceral involvement occurring mostly in patients with the human immunodeficiency virus (HIV).1 We describe a patient with HIV in whom an insidious ulcer developed as the marker for BA.

Report of a Case.  A 41-year-old white heterosexual promiscuous man was admitted to the hospital because of rectal bleeding and secondary anemia. His medical history included a serum sample positive for HIV antibodies and a 3-month history of a suppurative enlarging deep ulcer on his right ankle. Physical examination was significant for an ill-defined ulcer with a vegetative and fibrinopurulent 10×5-cm base over the right malleolus (Figure). Abnormal laboratory data included the following: leukocytes, 1.7×109/L (0.8 neutrophils, 0.5 lymphocytes, 0.9 monocytes, 1.3 erythrocytes, and 0.2 basophils); T4:T8 ratio, 20: 170; hemoglobin, 69 g/L; and hematocrit, 0.17. Because of the digestive bleeding, a gastrointestinal study, including fibrogastroscopy, colonoscopy, intestinal

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