Volume 16 - Issue 9 - September 2008

Patient Presentation A 40-year-old African-American woman presented with widespread tender, brown-grey plaques with red borders that developed over 2 days. The lesions spared her mucosal and palmoplantar areas. The only positive review of systems was general malaise. The patient’s past medical history was significant for HIV, for which the patient took anti-retroviral medications. She also reported that her infectious disease doctor had started her on a new medication (trimethoprim–sulfamethoxazole) a week prior to her presentation. Additionally, she reported a history of a similar single lesion on her leg that developed a year prior, which resolved in a few days, leaving behind a brown mark. At that time she had been taking a medication, Bactrim, which was discontinued by her doctor a month later. The patient denied any history of allergies. There was no pertinent family or social history.