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January 1996

Persistent Perineal Ulcerations

Author Affiliations

Southern Illinois University School of Medicine, Springfield

Arch Dermatol. 1996;132(1):81-82. doi:10.1001/archderm.1996.03890250091015

REPORT OF A CASE  A 26-year-old white man with the human immunodeficiency virus (HIV) presented with a 5-month history of nonhealing and painful ulcerations in the groin and perirectal region. These areas had previously been treated with bacitracin zinc and polymyxin B sulfate (Polysporin ointment), fluconazole, doxycycline, acyclovir, and rifampin, none of which resulted in improvement of the erosions. Previous cultures from the area yielded diphtheroids, Staphylococcus epidermidis, and Enterococcus faecalis.The physical examination revealed a well-defined 4-cm erythematous erosion with a slightly raised margin present within the right inguinal fold extending onto the upper medial aspect of the right thigh and onto the scrotal sac (Figure 1). In the perirectal region, there was an 8×5-cm erythematous erosion with a similar slightly elevated border without scaling (Figure 2). The erosions were covered with a yellow-white exudate. There was mild nontender inguinal adenopathy. Biopsy specimens were taken from the margins of

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