Secondary healed lesion right thigh

Secondary healed lesion in a 60-year-old cisgender man with HMPX and well-controlled HIV on Genvoya and Prezista, imaged at lesion day 7.

Located on the right lateral thigh is a healed lesion with 20-mm of poorly demarcated hyperpigmentation and fine peripheral scaling.  This lesion, part of a secondary crop of lesions, initially developed 36 days after illness onset.

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