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March 2006

Lichenoid Eruption in a Patient With AIDS—Quiz Case

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Arch Dermatol. 2006;142(3):385-390. doi:10.1001/archderm.142.3.385-b

A 34-year-old woman presented with a 7-day history of a mildly pruritic eruption on her back and extremities. On further investigation, we learned that approximately 8 months before presentation, she had been diagnosed as having human immunodeficiency virus. Her medical history was otherwise unremarkable. Serologic testing revealed that she had been infected with hepatitis B, syphilis, and toxoplasmosis. One month later, a blood culture was positive for Mycobacterium avium–intracellulare complex (MAC). Single-agent therapy with ethambutol hydrochloride was initiated because the patient was unable to tolerate azithromycin. Two months after her diagnosis, she began antiretroviral therapy, which was discontinued shortly thereafter because of noncompliance and intolerance. She also was diagnosed as having pneumonitis due to cytomegalovirus infection. A bone marrow biopsy specimen obtained 1 month later revealed granulomatous inflammation, but no infectious organism was identified.

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