A man with a history of human immunodeficiency virus (HIV) infection developed a painful rash. The patient had been in his usual state of health until three weeks before admission when an erythematous painful lesion developed on his arm. During the following weeks, skin lesions developed on his face, trunk, extremities, back and genitalia. He also developed headache, neck pain and photophobia. One week before presentation, lightheadedness and nausea occurred. He was brought to the emergency department for evaluation.
He reported some joint discomfort, without focal joint swelling or erythema. There was evidence of white plaques on the oral mucosa, suggestive of thrush. There was neck pain with flexion. The abdomen wastender in the right upper quadrant. Numerous infiltrated papules with variable amounts of scale were scattered over the face, arms, legs, and trunk (Images 1 and 2). Past…
