indinavir-sulfate and Paronychia

To assess a possible association between antiretroviral treatment and paronychia, we conducted a retrospective cohort study of 288 human immunodeficiency virus-positive protease inhibitor recipients. Indinavir treatment-adjusted for age, sex, CD4 count, diabetes status and other antiretroviral drug exposures-was significantly associated with paronychia of the great toe (hazard ratio 4.7; 95% confidence interval 1.6-13.9).

Topics: Adult; Aged; CD4 Lymphocyte Count; Cohort Studies; Female; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Indinavir; Male; Middle Aged; Paronychia; Retrospective Studies; Viral Load

A retrospective study of cases of paronychia associated with anti-retroviral therapy diagnosed in two general hospitals is here reported. Lesions appeared from 3 and 48 months after institution of therapy. At diagnosis, 84.6% of patients were on indinavir therapy. CD4 values ranged from 120 and 1,332 cells/mm3 and viral load was lower than 200 copies/ml in 92.3 of cases. Conservative therapy was applied in 7 patients and surgery in 6. In all patients indinavir therapy was discontinued, and cure was achieved 16 weeks later. The "retinoid" effect of indinavir is discussed as likely pathogenic explanation 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 complication (1.6% of our patients treated with anti-retroviral agents) makes its knowledge necessary and an active search by clinicians in patients receiving indinavir therapy.

Topics: Adult; Female; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Male; Paronychia; Retrospective Studies

The introduction of HIV-1 protease inhibitors into the treatment of patients infected with HIV-1 has had a major influence on clinical practice. However, the use of protease inhibitors is frequently associated with the development of resistance and several side effects and interactions with other drugs have been reported.. We present the first pediatric patient with paronychia with pyogenic granuloma associated with the administration of the protease inhibitor indinavir. Clinical findings are discussed in view of a possible interference of indinavir with endogenous retinoid metabolism.. Considerable evidence advocates the mediation of indinavir side effects by impaired oxidative metabolism of retinoic acid through the inhibition of cytochromes P450 3A by indinavir rather than by impaired formation of 9-cis-retinoic acid.

Topics: Adolescent; Child; Granuloma, Pyogenic; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Indinavir; Male; Paronychia; Retinoids; Skin Diseases; Toes

Topics: Adult; Fingers; Granulation Tissue; HIV Protease Inhibitors; Humans; Indinavir; Male; Paronychia; Proteus Infections; Proteus vulgaris; Staphylococcal Infections; Toes

Topics: Adolescent; Adult; Cheilitis; Female; HIV Infections; Humans; Indinavir; Male; Middle Aged; Nails, Ingrown; Paronychia; Protease Inhibitors; Skin Diseases; Time Factors

We report six HIV patients who developed painful periungual inflammation of several nails during treatment with the antiretroviral drugs indinavir and lamivudine. The lesions appeared 2-12 months after starting treatment. The occurrence of paronychia in HIV patients has recently been reported in two groups of patients receiving either indinavir or lamivudine. Dermatologists should be aware of this recently reported and probably not uncommon side-effect of antiretroviral treatment in order to avoid an invasive approach to the nail lesions.

Topics: Administration, Topical; Adult; Anti-Bacterial Agents; Anti-HIV Agents; Anti-Inflammatory Agents; Clobetasol; Drug Therapy, Combination; Female; Glucocorticoids; HIV Infections; Humans; Indinavir; Lamivudine; Male; Middle Aged; Mupirocin; Paronychia

Lamivudine and indinavir are two medications used to treat human immunodeficiency virus (HIV) that have recently been reported to cause paronychia. The nails of the great toes are commonly affected. This is the second report of paronychia and ingrown toenails due to indinavir and the first report of recurrent paronychia and ingrown toenails associated with this drug.

Topics: Adult; HIV Infections; HIV Protease Inhibitors; HIV-1; Humans; Indinavir; Male; Nails, Ingrown; Paronychia; Recurrence; Toes

Topics: Adult; AIDS-Related Opportunistic Infections; Female; Granuloma, Pyogenic; Hallux; HIV Protease Inhibitors; Humans; Indinavir; Male; Middle Aged; Nails, Ingrown; Paronychia