A 44-year-old Chinese man presented with a 3-week history of heat intolerance and a reduced ability to sweat even upon strenuous physical exertion. His medical history was significant for HIV infection on treatment with efavirenz and lamivudine/zidovudine. He also had drug reaction with eosinophilia and systemic symptoms (DRESS) to Bactrim 14 months prior, during which he developed a generalised exanthem. Physical examination revealed skin-coloured papules on his entire trunk with no visible beads of sweat despite having walked a distance in the afternoon heat to the consult room.
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