Diffuse cutaneous nodules in an HIV-infected child: The mystery unfolds

A 15-year-old female child who was diagnosed as HIV seropositive 5 months back presented to the Dermatology OPD with the presence of multiple intensely itchy oval to round papulo- nodular lesions of variable size scattered over her limbs, face, and trunk for last 3 months. The patient gave the history that the lesions first appeared over her limbs and then, gradually spread to her whole body without affecting mucous membranes and new lesions kept on appearing, whereas older lesions gradually increased in size over a period of last 3 months. A slit skin biopsy was done of the nodules and the Giemsa-stained impression smear revealed the following findings given in the picture and the patient was started on appropriate treatment.