Sexually transmitted infections

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Not only does the welcome long-term survival of HIV-infected patients put them at risk of ordinary age-related bone loss, antiretroviral therapy leads to a decline in bone mineral density. What can be done?

Because of this patient’s recent travel history to Africa, the penile lesions were cultured, and Haemophilus ducreyi was isolated, confirming the clinical suspicion of chancroid.

This is a classic case of herpes zoster. Note that the rash is limited to T5-6 dermatomes.

This clustered grouping of small, shallow erosions surmounting a slightly indurated plaque is characteristic for “cold sores.” Because no vesicles were present and the lesions appeared to be crusting over, the patient was advised to apply an OTC cream (docosanol 10%) per package insert instructions.

Condylomata acuminata this extensive are beyond the capacity of all topical therapies. The area was initially treated by carbon dioxide laser ablation, and residual small foci of infection were subsequently treated with topical 5% imiquimod cream.

Crusted Scabies

The combination of itching massive scaling suggests the diagnosis of crusted scabies. This variety of scabies is seen in those who are immunosuppressed or immunocompromised (typically HIV+). Repeated oral doses of ivermectin along with topical permethrin application were required to clear this infestation.

Scabies

This teen sought care because of extremely pruritic nodules on the penis and scrotum. He also had mild itching on the wrists and between several finger webs. This distribution of a pruritic dermatosis is classic for scabies.