Widespread Papules and Nodules in a Ugandan Man With Acquired Immunodeficiency Syndrome

Abstract

REPORT OF A CASE A 30-year-old man from Uganda, Africa, presented in October 1993 with a several-month history of a large, painful nodule on the right side of his forehead, which failed to heal despite oral and topical antibiotic therapy. He also complained of fever, night sweats, and a 4.5- to 6.8-kg weight loss. His medical history was unremarkable except for multiple female sexual partners. He denied homosexual encounters, intravenous drug use, or a history of blood transfusion. He had moved from Africa to California in 1992 and then to Colorado shortly thereafter. Physical examination revealed a tender, 2-cm-diameter ulcerated nodule on the right side of his forehead ( Figure 1 ). In addition, numerous 1- to 3-mm-diameter papules and pustules were noted on the face, neck, back, abdomen, and upper and lower extremities. The patient was unavailable for follow-up until January 1994, when he presented to the emergency department with a