Buschke-Lowenstein tumor in a woman living with HIV/AIDS

A 32-year-old woman presented with an 8-month history of verrucous and suppurative skin lesions on the anogenital area. She was diagnosed with human immunodeficiency virus (HIV) infection 18 months before and was receiving antiretroviral therapy thereafter. She underwent excision and experienced recurrence of perineal warts since the age of 28 years. Clinical examination showed oval hyperchromic keratotic plaques on the perineum, and extensive verrucous masses located on the left buttock that were painful to touch, friable, and foul-smelling, with some bleeding and purulent exudate on the surface (Figure A). The cluster of differentiation 4 (CD4) count was 219 cells/mm³ and the HIV viral load was undetectable.