This severe case of large perforating dermatoses was an unusual symptom of HIV for a female Latvian patient.

The patient, aged in her 40s, presented with crateriform ulcerations with serous discharge across her lower extremities, gluteal region, lower back and arms, doctors at Riga East University Hospital reported.

Some lesions had coalesced into larger ulcers with severe pruritus and intermittent bleeding, many larger than a centimetre.

The eruption, which had begun a year earlier as pruritic papules and nodules, had previously been diagnosed as prurigo nodularis (PN).