Figure 1.

Multiple yellowish or hemorrhagic crust-covered lesions on the face, including the lips and ala nasi (A). Onychauxis (thickening and transverse ridging) of the right index fingernail, with a large surrounding area of paronychia (B). Multiple cutaneous ulcers of varying sizes, some surrounded by violaceous erythema and rolled borders (C, D). Shallow, fibrin-covered ulcers on the dorsum of the tongue (E). Ulcerative balanitis (F). Sausage-shaped fingers (G). Nail dystrophy and distal detachment from the nail bed (onycholysis) of several fingernails, with a bizarre aspect (H). This figure appears in color at www.ajtmh.org.