A 38-year-old man with an H/o HIV-seropositive established two years earlier visited the hospital with complaints of fever, chills, malaise, and multiple cutaneous lesions with a purulent secretion that covered his face, scalp, and body. The skin lesions had appeared several months before a diagnosis. The figure shows that the most significant necrotic lesions occurred on his lips, producing numerous purulent secretions. Initial clinical examinations included varicella pustulosa and staphylococcal dermatitis. The patient was febrile and had lymphadenopathy and oropharyngeal candidiasis. An X-ray of his lungs and heart revealed no pathological findings. The laboratory work showed evidence of anaemia, high leucocytosis and agranulocytosis. Immune status analyses revealed a CD4: 208 cells/μl, a CD8:845 cells/μl, and a CD4/CD8:0.20.
A skin biopsy and histological investigation showed non-specific inflammatory changes: moderate mixed inflammatory infiltrates located peri vascularly throughout the dermis, which was composed of lymphocytes, plasmacytes, and polymorphonuclear cells.
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