The papular eruption (PE) associated with human immunodeficiency virus infection, although described as a distinctive clinicopathologic entity, has shown a wide range of histologic findings ranging from eosinophilic folliculitis to granuloma annulare. We examined 48 cases of the PE in order to define the histologic spectrum of these lesions, and to correlate these findings with clinical presentations. The most distinctive clinical features are the frequency of these lesions in this population, the large number of lesions, pruritus, and the chronic nature of the lesions. Histologically, the distinctive features are the prominent perivascular factor XIIIa-positive dermal dendritic cells, atypical vascular proliferation, and dermal fibrosis sometimes associated with diffuse necrobiotic changes.