Secondary plantar pustule in a 36-year-old cisgender man with HMPX, imaged at lesion day 2.
Located on the left plantar surface is a single 1-2-mm pustule surrounded by light pink erythema that was nontender and nonpruritic. Part of a secondary crop of lesions, this pustule developed on illness day 7, and was accompanied by the onset of numerous mildly tender and mildly pruritic lesions on the face, scalp, torso, genitals, and bilateral upper extremities.
His illness began as a single pustular lesion on the right fourth finger, followed by systemic symptoms (fever, chills, sweats, fatigue, myalgias, arthralgias, and back pain) on illness day 4. There was no history of immunocompromising conditions or medications. This man was on Truvada for HIV pre-exposure prophylaxis.