case_images: PMC11233042_01
case_images: Pretreatment images of the patient. Erythematous maculopapular rash over the face and multiple ulcers and crusted erosions over the lips and oral mucosa (a), dusky erythematous maculopapular rash over the trunk (b), erythematous macules and papules over the palms (c), and erythematous papules over the soles (d)
case_images: IJSTD-45-59-g001.jpg
case_images: PMC11233042_01_IJSTD-45-59-g001.jpg
case_images: ijstd_69_23-f001
case_images: Within 6 days of starting tablet efavirenz, he developed fever, erythematous nonscaly maculopapular rash covering the cheeks, nasal bridge, forehead sparing the nasolabial folds, trunk, B/L upper limbs, lower limbs, erythematous papules on the palms and feet, multiple ulcers, and crusted erosions over the lips and hard palate [Figure 1].
case_images: Skin biopsy Hematoxylin and Eosin stain (a) H and E, x100; basal layer vacuolization and interface dermatitis, superficial perivascular, and perifollicular infiltrate composed of neutrophils and lymphocytes in the dermis, (b) H and E, x400; interface dermatitis, superficial perivascular, and perifollicular infiltrate composed of neutrophils and lymphocytes in the dermis
case_images: IJSTD-45-59-g002.jpg
case_images: PMC11233042_01_IJSTD-45-59-g002.jpg
case_images: ijstd_69_23-f002
case_images: Skin biopsy findings include interface dermatitis, necrotic keratinocytes with perivascular and periappendageal inflammatory infiltrate suggesting the diagnosis of lupus erythematosus [Figure 2a,b].
case_images: Posttreatment images of the patient. Resolved erythema and maculopapular rash over the face and clearance of oral mucosal lesions (a), postinflammatory hyperpigmentation after resolution of rash over the trunk (b), resolution of erythematous macules and papules over the palms (c), and resolution of erythematous papules over the soles (d)
case_images: IJSTD-45-59-g003.jpg
case_images: PMC11233042_01_IJSTD-45-59-g003.jpg
case_images: ijstd_69_23-f003
case_images: Significant improvement was observed with marked clearance of skin lesions, oral ulcers, and no fresh complaints at 3 months of follow-up [Figure 3].