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Perianal Ulcer in a Patient With AIDS—Quiz Case
CPT Jon H. Meyerle, MC, USA;
COL George W. Turiansky, MC, USA
Walter Reed Army Medical Center, Washington, DC
Arch Dermatol. 2004;140:877-882.
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REPORT OF A CASE
A 52-year-old white man with AIDS and a CD4 cell count of 5/µL developed a solitary, tender 2-cm punched-out, deep perianal ulcer with an erythematous scalloped border (Figure 1). The ulcer was initially attributed to herpes simplex virus (HSV) infection, as the patient had a history of perianal HSV 1 infection. He was treated for more than 1 year with high-dose oral acyclovir therapy and wound care, without improvement. His general health was complicated by pulmonary and cutaneous Kaposi sarcoma, Pneumocystis carinii pneumonia, esophageal candidiasis, duodenitis, lumbar plexopathy secondary to HSV, cytomegalovirus (CMV) retinitis, hypertension, and gastroesophageal reflux disease. His medications at presentation included zidovudine, lamivudine, indinavir sulfate, acyclovir, sulfamethoxazole-trimethoprim (double-strength), fluconazole, lisinopril, propranolol hydrochloride, omeprazole, and doxepin hydrochloride. The differential diagnosis included lymphoma, Kaposi sarcoma, squamous cell carcinoma, and infection with atypical mycobacteria, deep fungi, . . . [Full Text of this Article]
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Perianal Ulcer in a Patient With AIDS—Diagnosis
Arch Dermatol. 2004;140(7):877-882.
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