Infectious Diseases and Tropical Medicine (Apr 2023)

Answer to the photoquiz: Generalized violaceous papulosquamous eruptions in an HIV-positive female

  • A. Valluri,
  • S. Subhadarshani

DOI
https://doi.org/10.32113/idtm_20234_1109
Journal volume & issue
Vol. 9

Abstract

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A 25-year-old woman gravida 2, para 2, presented to the dermatology clinic for evaluation of a one-month history of a generalized asymptomatic rash. The patient had a history of poorly controlled Human Immunodeficiency Virus (HIV) infection with non-compliance to antiretroviral therapy, and prior chlamydia and gonorrhea infections. Additionally, she complained of a headache, which was unrelieved by aspirin, paracetamol, and caffeine. The patient denied vomiting, neck stiffness, tingling, numbness, or fatigue. Mucocutaneous examination revealed several ill-defined violaceous papules and plaques with peripheral scaling over her face, trunk, and extremities, including her palms and soles. Additionally, there were multiple ill-defined healing erosions with peripheral serpiginous violaceous borders present in the buccal mucosa. The lesions over the palms and soles were well-demarcated with a coppery hue. Furthermore, there were well-defined violaceous papules over the labia majora. Severe tenderness was elicited by applying gentle pressure to the lesions on the back. See the question at https://www.infectiousjournal.com/article/1097. What is the diagnosis? A) Subacute Cutaneous Lupus Erythematosus B) Rocky Mountain Spotted Fever C) Lichen Planus D) Secondary Syphilis The correct answer is D – Secondary Syphilis.

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