PMC4066599_01
Clinical photograph showing multiple erosions with crusts and scars over the dorsum of both hands
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F1
Physical examination revealed multiple erosions with crusts, scars over the dorsum of both hands [Figure 1] and face.
Minimal hypertrichosis and erosions with crusts over the left side of the face
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F2
Minimal hypertrichosis of the face was present [Figure 2].
Bright pink fluorescence on woods lamp examination
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F3
Examination of urine under Wood's light revealed a bright pink fluorescence consistent with the presence of porphyrins [Figure 3].
A pauci-inflammatory subepidermal bulla with hemorrhage and periodic acid-Schiff (PAS) positive material around dermal capillaries. The floor of the bulla shows preserved dermal papillae (PAS magnification, x10)
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F4
There was deposition of periodic acid-Schiff (PAS) stained material around the dermal capillary blood vessels [Figure 4].
Resolution of the erosions over the dorsum of both hands
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F5
Three months following the initiation of treatment, there was clinical remission of the skin lesions [Figure 5] with a CD4 count of 232 cells/mm3.