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Painful Plaques on the Soles of an HIV-Positive Man
Nancy L. Marchell, MD;
Jason Lupton, MD;
Mervyn L. Elgart, MD
George Washington University School of Medicine, Washington, DC
Arch Dermatol. 2002;138:973-978.
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REPORT OF A CASE
A 36 year-old human immunodeficiency virus (HIV)-positive African American
man presented with painful lesions on the soles of his feet. He stated that
he had been treated with several applications of permethrin for pruritic lesions
on his trunk 5 months earlier. The lesions resolved, and 3 months later he
discovered several lesions on his feet that were painful rather than pruritic.
On physical examination, there were several hyperkeratotic plaques ranging
from 1.5 to 2.5 cm in diameter on the soles of his feet (Figure 1). His palms were not involved. On debridement of the lesions,
marked hyperkeratosis was noted. A shave biopsy specimen was obtained (Figure 2).
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Figure 1.
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Figure 2.
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What is your diagnosis?
Diagnosis: Crusted (Norwegian) scabies.
Microscopic examination of the biopsy specimen revealed the presence
of eggs and feces within the stratum corneum, consistent with S . . . [Full Text of this Article]
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