Secondary penile healed lesion

Secondary penile healed lesion in a 33-year-old cisgender man with HMPX and well-controlled HIV on Biktarvy.

Located on the foreskin is a 2-mm nontender, nonpruritic healed lesion that is flat with central hypopigmentation. This lesion, likely part of a secondary crop of lesions, was identified in this healed stage at the time of diagnosis (illness day 19) and was associated with other secondary lesions on the left flank, left anterior knee, and right olecranon process.

This secondary crop of lesions was preceded by pharyngitis, fever, and headache on illness day 1 and severely tender and pruritic perianal lesions on illness day 3 before the onset of his secondary crop of lesions one week later.