History: A 51 year-old African-American male presented to clinic with a 1 week history of a rash that started on his thighs and then spread to involve his entire body. Rash was non-pruritic and non-painful.
Past Medical History: HIV/AIDS, most recent CD4 count was 120 and HIV viral load was 442,000. Patient had been off of HAART therapy for 6 months. Also has history of neurosyphilis that was treated 1 year ago. An RPR drawn 3 days prior to presentation was negative.
Physical Exam: Erythematous slightly scaly papules were present diffusely over body, 5-8 mm in size (Fig. 1). Reddish-brown macules on palms and soles abutting the palmar and plantar creases (Figs.2,3). A few superficial erosions were present on the oral mucosa. Papules, some with a slightly eroded surface, were present on the scrotum (Fig 4).
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