Derm Dx: Penile lesions in an HIV-positive man

A 52-year-old, HIV-positive man presents with a several-month history of penile lesions. The sites are moderately tender. Current medications include etravirine, ritonavir, darunavir, and emtricitabine/tenofovir. Culture was positive for herpes simplex, but the condition has persisted despite topical treatment with acyclovir ointment and oral acyclovir.