A 37-year-old man with acquired immunodeficiency syndrome presented with a 3-month history of slightly pruritic plaques on the sun-exposed areas of his face and arms. The lesions developed quickly and then stabilized and persisted. They were unresponsive to treatment with 0.2% hydrocortisone valerate cream or 0.05% clobetasol propionate cream.

On physical examination, there were multiple, well-defined, dusky, purple plaques located on the sun-exposed areas of the face (Figure 1), including the upper lip; anterior aspect of the neck; upper chest area; and dorsal aspect of the hands (Figure 2). Several of the lesions had a fine scale. There were no other oral or other mucosal findings.