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February 1, 2008

Psoriasiform Eruption and Pharyngitis—Quiz Case

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Arch Dermatol. 2008;144(2):255-260. doi:10.1001/archdermatol.2007.43-a

A 37-year-old white man with human immunodeficiency virus (HIV) infection presented with a 3-month history of an eruption to his hands and feet associated with malaise and sore throat. Physical examination revealed multiple erythematous hyperkeratotic plaques with cracks and fissures to the hands and to the soles (Figure 1). All nail plates of the feet and some nail plates of the hands appeared dystrophic and roughened (Figure 2). Moist, perianal papules were also observed. Associated findings were pharyngitis and diffuse lymphadenopathy. Plasma HIV RNA level was 46 032 copies/mL, and leukocytes were 6080 cells/μL (reference range, 4500-11 000 cells/μL), with 317 T cells/μL (reference range, 400-1500 cells/μL). (To convert leukocytes and T cells to number of cells × 109 per liter, multiply by 0.001.) A biopsy specimen was obtained from the right sole (Figure 3 and Figure 4).

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