Cutaneous Ulcers in an Untreated HIV Patient

摘要

A 22-year-old man presented with a 6-month history of asthenia, anorexia, severe weight loss of 20 kg, low-grade fever, and cutaneous lesions that had occurred within 1 month. More importantly, this patient presented with untreated HIV infection. Physical examination revealed a few erythematous and ulcerated plaques (some with necrotic crusts) on his trunk and extremities (Figure 1) and absence of lesions on mucous membranes, palms and soles. Blood tests showed 284 CD4/μL and HIV viral load 243,000 copies/mL. Nontreponemal tests showed elevated VDRL titers (1/32). Lumbar puncture ruled out neurosyphilis. With a diagnosis of malignant syphilis, benzathine penicillin 2.4 MU was administered intramuscularly with complete resolution of symptoms.