Abstract
A 34-year-old man with history of HIV on antiretroviral therapy was admitted with skin rash and 2 weeks of rectal pain and bleeding. He reported anoreceptive intercourse with a male partner 3 weeks prior. His most recent CD4 count from 6 weeks prior was 693 cells/mm3. Physical examination revealed papular lesions on his face, trunk, arms, and buttocks (Figure A). He had no perianal lesions but experienced exquisite tenderness with digital rectal examination. Computed tomography of the pelvis demonstrated rectal wall thickening with perirectal fat stranding and reactive lymphadenopathy.
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