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December 1994

Rapidly Progressing Nodule in a Patient With the Acquired Immunodeficiency Syndrome

Author Affiliations

Vanderbilt University, Nashville, Tenn

Arch Dermatol. 1994;130(12):1556. doi:10.1001/archderm.1994.01690120097016

REPORT OF A CASE  A 31-year-old man with the acquired immunodeficiency syndrome (AIDS) presented with a 3-month history of a rapidly progressing painful lesion of the right shoulder. Initially an infectious cause was postulated, but cultures showed only a light growth of mixed gram-positive organisms and there was no clinical response to cephalexin.His history was significant for a 3-year history of AIDS manifested by positive tests for the human immunodeficiency virus (HIV), recurrent candidiasis, herpes zoster, and AIDS dementia but no adenopathy or Kaposi's sarcoma.Physical examination revealed a 5 ×4-cm lesion of the right shoulder with central necrosis and a heaped-up smooth pearly border (Figure 1). There was no adenopathy.A biopsy specimen at the edge of the lesion was obtained for both pathologic review (Figure 2 and Figure 3) and cultures.What is your diagnosis?

Figure 1  .

Figure 2  .

Figure 3  .

Rapidly Progressing Nodule in a Patient 

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