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SKINDIA QUIZ
Year : 2013  |  Volume : 4  |  Issue : 3  |  Page : 257-258  

SkIndia Quiz 10 - Papulonodular lesions in a Human Immunodeficiency Virus-positive patient


Department of Dermatology, Venereology and Leprosy, R.N.T. Medical College, Udaipur, Rajasthan, India

Date of Web Publication24-Jul-2013

Correspondence Address:
Lalit Kumar Gupta
3-A, Sai Villa, Madhuvan, Opp. G.P.O., Udaipur - 313 001, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.110655

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How to cite this article:
Gupta LK, Pargi S, Khare AK, Mittal A, Mehta S, Kuldeep C M. SkIndia Quiz 10 - Papulonodular lesions in a Human Immunodeficiency Virus-positive patient. Indian Dermatol Online J 2013;4:257-8

How to cite this URL:
Gupta LK, Pargi S, Khare AK, Mittal A, Mehta S, Kuldeep C M. SkIndia Quiz 10 - Papulonodular lesions in a Human Immunodeficiency Virus-positive patient. Indian Dermatol Online J [serial online] 2013 [cited 2019 Dec 10];4:257-8. Available from: http://www.idoj.in/text.asp?2013/4/3/257/110655

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A 45-year-old male known to be human immunodeficiency virus (HIV)-positive and on anti-retroviral treatment for 3 years, presented with generalized, mildly itchy, firm, shiny, skin colored, papulonodular lesions present symmetrically on face, trunk, buttocks and extremities for 3 months. The lesions were most prominent around ear, ala nasi [Figure 1]a, knuckles, elbows [Figure 1]b, knee, buttocks [Figure 1]c, palms [Figure 1]d, and soles. Eroded papulonodules were also seen on hard palate [Figure 1]a. Some of the lesions morphologically resembled molluscum contagiosum [Figure 1]c. Generalized lymphadenopathy was noted. He was otherwise in good health. His CD4 count was 15 cells/mm 3 and other blood counts, liver function tests, andrenal function tests were within normal limits. X-ray chest was normal. Abdominal ultrasonography revealed hepatosplenomegaly. Culture from skin lesion was negative. Histopathological examination of the lesions demonstrated epidermal atrophy and granulomatous infiltrate [Figure 2]a with parasitized histiocytes [Figure 2]b in the and entire dermis.
Figure 1: Shiny papules around alanasi, chin and oral cavity (a), elbows (b), buttocks (c), and palms (d)

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Figure 2: (a) Histiocytic granulomatous infiltrate in the dermis (H & E, ×40), (b) presence of numerous parasitized macrophages in the dermis (H & E, 1000x)

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   What is the Diagnosis? Top





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   References Top

1.Singhi MK, Gupta L, Kacchawa D, Gupta D. Disseminated primary cutaneous histoplasmosis successfully treated with itraconazole. Indian J Dermatol Venereol Leprol 2003;69:405-7.  Back to cited text no. 1
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2.Joshi SA, Kagal AS, Bharadwaj RS, Kulkarni SS, Jadhav MV. Disseminated histoplamosis. Indian J Med Microbiol 2006;24:297-8.  Back to cited text no. 2
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3.Dhar S, Dutta Roy RK, Todi SK, Roy S, Dhar S. Seven cases of histoplasmosis: Cutaneous and extracutaneous involvements. Indian J Dermatol 2006;51:137-9.  Back to cited text no. 3
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4.Vasudevan B, Ashish B, Amitabh S, Mohanty AP. Primary cutaneous histoplasmosis in a HIV-Positive Individual. J Glob Infect Dis 2010;2:112-5.  Back to cited text no. 4
    
5.Bhagwat PV, Hanumanthayya K, Tophakhane RS, Rathod RM. Two unusual cases of histoplasmosis in human immunodeficiency virus-infected individuals. Indian J Dermatol Venereol Leprol 2009;75:173-6.  Back to cited text no. 5
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6.Hinshow M, Longley BJ. Fungal disease. In: Elder DE, Elenitsas R, Murphy GF, Johnson BL, Xu X, editors. Lever's Histopathology of the Skin. 10 th ed. New Delhi: Wolters Kluwer (South Asian edition); 2010. p. 611-2.  Back to cited text no. 6
    
7.Paul AY, Aldrich S, Scott RS, Ellis MW. Disseminated histoplasmosis in a patient with AIDS: Case report and review of the literature. Cutis 2007;80:309-12.  Back to cited text no. 7
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