PMC5881977_01
(a, b) Maculo-papular rash on volar aspect of both forearms; (c) purplish, opaque, rough, vertically ridged, plaque-like lesions on the left hand index finger; and (d) same lesion type on the right hand little finger.
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At that time, the patient's CD4 count was 505/microL and the viral load was <20 copies/mL. A physical examination evidenced an enlarged left inguinal lymph node, hepatosplenomegaly, and a barely discernible macular, pink rash on the trunk not involving the palms and soles, coexisting with maculo-papular lesions localized on the proximal volar aspect of both forearms (Figure 1(a) and (b)). There was no discernible involvement of the periungual skin (Figure 1(c) and (d)).
Following the administration of penicillin: (a) resolution of nail lesions and (b) linear scar on the right little finger.
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Five months from the end of therapy, the fingernails were free of disease, with the exception of a linear scar on the left little fingernail (Figure 2(a) and (b)), and all the abnormal blood test, including the liver enzymes, resulted normal.