Case History
A 34-year-old lady was diagnosed with HIV and started on Anti-retroviral therapy with regimen TDF (Tenofovir disoproxil fumarate) +3TC(Lamivudine)+NVP(Nevirapine). After three months of medications, the patient noticed multiple reddish lesions on bilateral legs associated with itching and pain. There were no systemic complaints. Initially, NVP was thought to be the cause of the rash and thus the drug was stopped. The patient was prescribed tapering doses of oral steroids that relieved her lesions. After 2 weeks of stoppage of oral steroids, she again developed similar new lesions with similar progression, for which she visited our OPD.
Cutaneous examination showed multiple purpura and petechiae distributed symmetrically on bilateral legs extending up to mid-thigh (Fig 1). Systemic examination did not reveal any abnormalities.