Scaly lesions on the palms and soles

An African American man, aged 45 years, presented for evaluation of new lesions on the palms and soles. He reported that the rash began three weeks ago as "dark spots." Over time, the lesions developed a scaly appearance. The lesions were asymptomatic. His medical history was notable for a recent diagnosis of human immunodeficiency virus infection. Physical examination revealed hyperpigmented ...