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Hyperkeratotic varicella zoster virus infection in an HIV‐infected patient. Successful treatment of persistent lesions with cryosurgery

without untoward side-effects. No further ulceration has been seen during subsequent follow-up. Skin and mucous membrane ulceration has been reported in some psoriatic patients treated with oral retinoids or methotrexate. The clinical course in this patient argues against methotrexate as the causative agent, as this drug was not stopped and the ulcers healed after cessation of tazarotene treatment. Tazarotene, like other topical retinoids, has the potential to cause irritation. In clinical studies world-wide, ulceration has not been reported. In the present case, the accidental genital contact with the tazarotene gel, diabetes and systemic methotrexate may have combined to result in genital ulceration. Although tazarotene gel is not recommended for use in the genital region, accidental application during treatment cannot be avoided.