Nail, Hair, And Skin Hyperpigmentation Associated With Indinavir Therapy

The document described the first reported case of reversible nail, hair, and skin hyperpigmentation associated with ritonavir-boosted indinavir therapy in a 42-year-old black patient with HIV-2. The patient experienced significant improvements in CD4 count and viral load after switching to indinavir-based therapy but developed hyperpigmentation and renal issues. Upon discontinuation of indinavir, the hyperpigmentation resolved within 6 months. The study noted that more than 50% of patients on indinavir experienced cutaneous adverse effects, but no link was found between these effects and HIV disease markers. The hyperpigmentation was unlikely due to indinavir's retinoic acid-like effects, suggesting a need for further histopathological investigation.