Patient with AIDS and Acute Circinate Skin Eruptions

Figure 1. A polycyclic, papular eruption on the face. A 24-year-old transgender woman with Treacher-Collins syndrome (mandibulofacial dysostosis) and AIDS (CD4 + cell count, 151 cells/mm 3) presented with a 1-month history of a pruritic, mildly erythematous, polycyclic papular eruption distributed diffusely over her face. She had no history of any similar eruptions and no history of facial implants or facial surgeries for Treacher-Collins syndrome. She denied fever, chills, or other systemic symptoms and had no contact with plants, metals, or new cosmetics. The remaining findings of the review of systems were unremarkable. The patient had been sexually active within the previous 6 months, often without barrier protection. She had received a diagnosis of AIDS 4 years earlier and had been receiving continuous antiretroviral therapy , with the exception of a break in therapy just prior to the onset of the skin eruption. The patient had no recent travel