Secondary crusted lesion

Secondary crusted lesion in a 60-year-old cisgender man with HMPX and well-controlled HIV on Genvoya and Prezista, imaged at lesion day 18.

Overlying the right knee is a 10-mm nontender, nonpruritic scabbed lesion with peripheral flaking.  This lesion, part of a secondary crop of lesions, developed 7 days after illness onset, and was initially pruritic but nontender.

This lesion was preceded by initial symptoms of right periauricular pain, headache, fever, chills, and malaise on day 1, tender bilateral inguinal lymphadenopathy on day 2, perioral and exquisitely tender and pruritic perianal lesions on day 5, and over the next week, lesions appearing on the trunk, extremities, and genitals.