A 39-year-old man with HIV presents with a 1-year history of recurrent, painful penile ulcers. Biopsy reveals unusual features. What’s the diagnosis?
A 39-year-old man with human immunodeficiency virus infection that was being treated with antiretroviral therapy presented to the dermatology clinic with a 1-year history of recurrent, painful penile ulcers. Approximately once per month, erosions would appear ulcerate, heal spontaneously and then recur. Laboratory testing showed a CD4 cell count of 494 per cubic millimeter (reference range, 414 to 1123) and an HIV viral load of 450 copies per milliliter (reference range, <20). Biopsies of the lesions revealed epidermal necrosis, pseudoepitheliomatous epidermal hyperplasia, and a dense infiltrate of inflammatory cells in the dermis and subcutaneous tissue. Next-generation sequencing (NGS) of the tissue was performed. What is the most likely diagnosis?
What is the most likely diagnosis?
Genital ulcers, Herpes Simplex Virus, Herpes vegetans, HIV, Immunocompromise
