Cutaneous Mycobacteriosis: Occurrence and Significance in Two Patients With the Acquired Immunodeficiency Syndrome

TO THE EDITOR.— Mycobacterial skin lesions classically present as nodules, abscesses, or indolent ulcers at sites of minor trauma, including injection sites, indicating local infection.1 Mycobacterial skin nodules have been described in systemic mycobacteriosis.2,3 Since disseminated mycobacterial infection is frequent in patients with the acquired immunodeficiency syndrome (AIDS),4 mycobacterial skin lesions in these patients can be presumed to indicate systemic infection. We describe here three variants of mycobacterial skin lesions in two patients with AIDS, both of whom had disseminated infection confirmed at autopsy. Furthermore, we recommend biopsy and culture of suspicious skin lesions as noninvasive tools for diagnosing mycobacterial infection in patients with AIDS. REPORT OF CASES.— Case 1.—A 29-year-old Hispanic man with risk factors of homosexuality and chronic intravenous (IV) drug abuse was hospitalized for fever, cough, and shortness of breath of two days' duration. His history was significant for recurrent opportunistic infections (oral and