Multiple choice: erythematous papules and nodules in a HIV patient

Abstract

A 39-year-old male, with a history of HIV infection, was hospitalized for pneumonia due to an unknown germ. On physical examination, he had erythematous papules, some ulcerated, 0.5 to 1.5 cm in diameter, on the chest and abdomen. Erythematous-violaceous nodules, with a hard-elastic consistency, 2 cm in diameter, on both legs. In addition, generalized lymphadenopathy was observed. A biopsy of the skin lesions was performed, and granulomas with a necrobiotic center and mixed inflammatory infiltrate with multiple intensely PAS-positive intracellular rounded bodies were observed. Complementary studies were requested according to the diagnostic suspicion.