Chronic Recurrent Folliculitis with Atypical Hyperpigmented Scarring in an AIDS Patient

ABSTRACT

Bacterial, fungal, and viral infections of the skin with extended skin involvement can occur during the early phase of human immunodeficiency virus infection. A significant reduction in circulating CD4+ lymphocytes in the late stage of the disease may cause tumors of the skin such as Kaposi's sarcoma. A 40-year male patient, a former sailor who had multiple sexual contact with native African women, presented with multiple tender follicular pustules and fibrotic brown patches on both his legs. these had been present for 6 months. The skin lesions were healed leaving brown pigmentation. Laboratory examinations revealed the presence of leukopenia, thromocytopenia and a reversed T4/T8 ratio. The ELISA and Western blot analysis to human immunodeficiency virus were positive. A skin biopsy from a brown patch showed early stages of scar tissue and perivascular hemosiderin deposition. We herein report a case of acquired immunodeficiency syndrome patient with atypical dark brown scarring atrophic patches on the lower legs following purulent bacterial folliculitis. This may have been an early manifestation of Kaposi's sarcoma from a preceding skin lesion.