Azidothymidine-Induced Hyperpigmentation of Skin and Nails

Abstract

<h3>To the Editor.—</h3> In the treatment of patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex, azidothymidine (zidovudine, Retrovir) plays a significant role: it is the only medication with clinically proven antiretroviral activity currently available. It is used on a large scale worldwide. Most side effects reported so far refer to the myelotoxicity of azidothymidine,¹there are only a few reports on adverse experiences involving the skin and its adnexes. Recently, Azon-Masoliver et al²reported in theArchiveson their observation of longitudinal streaks appearing on the fingernails of two white patients 4 and 6 months after the start of therapy with azidothymidine. Panwalker³as well as Furth and Kazakis⁴described a bluish discoloration involving the entire nail plate of both fingernails and toenails that they observed in black individuals 2 weeks to 6 months after the start of azidothymidine treatment. Herein we describe the development of