Secondary pustule in a 60-year-old cisgender man with HMPX and well-controlled HIV on Genvoya and Prezista, imaged at lesion day 1.
Located on the right lateral thigh is a pinpoint pustule with a 30-mm diameter of poorly demarcated erythema that was pruritic but nontender. This lesion, part of a secondary crop of lesions, developed the same day this image was captured, 36 days after illness onset.
This lesion was preceded by initial symptoms of 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.