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Off-Center Fold
December 2009

Widespread Crusted Lesions in a Patient With HIV—Quiz Case

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Arch Dermatol. 2009;145(12):1447-1452. doi:10.1001/archdermatol.2009.286-a

A 22-year-old Brazilian man presented with an 8-month history of widespread, gradually progressive cutaneous lesions. Six months earlier, he was found to be seropositive for the human immunodeficiency virus (HIV), but he was not undergoing antiretroviral therapy. The patient complained of fatigue and weight loss. Physical examination showed multiple, mildly pruriginous, painful, partly ulcerated, crusted papules and plaques disseminated on the face, trunk, and extremities (Figure 1) without mucosal involvement. Axillary and inguinal lymphadenomegalia was noted. Cough and fever were not present, and rapid plasma reagin findings were negative.

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