A 40-year-old HIV-positive Haitian woman (Table, patient 2), was seen for a pruritic eruption on her face that had begun 1 month earlier. She was severely immunocompromised (CD4 cell count, 77/mm3 and viremia, HIV RNA load of 391 000 copies/mL) at the time of presentation. On examination, she had papules, microcysts, and pigmented macules localized on her face only. A diagnosis of inflammatory folliculitis was made in the absence of superficial bacterial, viral, or fungal infection. Results from a skin biopsy confirmed the diagnosis of HIV-EF. Various topical treatments (erythromycin, tretinoin, clindamycin phosphate, adapalene, and metronidazole) as well as H1 receptor antagonists were ineffective. Subsequent treatment with oral doxycycline and topical clobetasone propionate gave some improvement. Treatment with HAART (stavudine, lamivudine, lopinavir, and ritonavir) was introduced 2 months later, but the symptoms became more severe.