Paronychia in HIV-positive patients treated with indinavir

A retrospective study of cases of paronychia associated with anti-retrovira l therapy diagnosed in two general hospitals is here reported. Lesions appe ared from 3 and 48 months after institution of therapy. At diagnosis, 84.6% of patients were on indinavir therapy. CD4 valus ranged from 120 and 1,332 cells/mm(3) and viral load was lower than 200 copies/ml in 92.3 of cases. Conservative therapy was aplied in 7 patients and surgery in 6. In all pati ents indinavir therapy was discontinued, and cure was achieved 16 weeks lat er. The retinoid effect of indinavir is discussed as likely pathogenic expl anation for this complications. We advocate for topic therapy and change of anti-retroviral therapy, reserving surgery for patients not responding to therapy. Pain and functional limitation caused by this non uncommon complic ation (1.6% of our patients treated with antirtroviral agents) makes its kn owledge necessary and an active search by clinicians in patients receiving indinavir therapy.