A painless lesion on the leg and a painful lesion on the tongue. What is the diagnosis?

D Zieff, M Pandie, M Mendelson

Abstract


A 28-year-old HIV-seropositive man presented to clinic with a four-month history of a rash on his right lower limb.
The rash began as painless macules which formed nodules and coalesced (Figure a). Over the last month, new skin lesions had formed on his torso (Figure b) and a painful lesion of his tongue (Figure c) had increased in size, making speech difficult. His chest x-ray was unremarkable and there was no clinical or radiological evidence of organomegaly. A recent CD4 count was 15 cells/μL and he was antiretroviral naïve.

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