Mystery Quiz

November 10, 2010


Dana Clutter, MD

Edited by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

A 25 year old woman infected with HIV presents to an HIV/AIDS clinic in Kampala, Uganda, for evaluation of cutaneous lesions on her face, arms and back. Aside from the disfiguring nature of her lesions, she reports being in her usual state of health. She denies any constitutional symptoms and all of her vital signs are stable. Her current CD4+ T cell count is 1 cell/cmm and she has never been on antiretroviral therapy. Two lesions from her initial presentation are pictured below. They were tender and had a rubbery consistency. A punch biopsy of a representative lesion was performed. Out of concern for superinfection of several lesions, including the pictured facial lesion, erythromycin was started.


What is the most likely diagnosis?

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Dr. Clutter is a 1st year resident at NYU Langone Medical Center.

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