Ulcer over Chin in an Immunocompromised Individual

Abstract

A 45-year-old human immunodeficiency virus (HIV)-positive man from northeastern India [Tamil Nadu] presented with fever, cough and a 3-month-old ulcer over his chin. On examination, there was a 5×5 cm superficial ulcer with a thick adherent crust over the chin. He had 3 papules with central umbilication over the neck and face. He had anaemia and a CD4 count of 89 cells/µl. His chest radiograph and thoracic computed tomography scan showed right mid- and lower-zone consolidation. Histopathology of the umbilicated papule and ulcer as well as tissue cultures from skin lesions and bronchoalveolar lavage aspirates revealed Penicillium marneffei infection.