Active secondary scalp ulcer

Active secondary scalp ulcer in a 30-year-old cisgender man with HMPX, imaged at lesion day 3.

Located on the scalp is a 1-2-mm ulcer with a wet base and a small diameter of poorly demarcated erythema. Part of a secondary crop of lesions, this lesion was first noticed as focal scalp pruritis on illness day 10, was associated with nontender cervical lymphadenopathy, and had completely healed with no signs of a scar and resolved pruritis by follow-up on lesion day 12.

There was no history of immunocompromising conditions or medications.  This man was on Truvada for HIV pre-exposure prophylaxis. He also received Imvamune for HMPX pre-exposure prophylaxis 3 days before illness onset.