Striate palmar keratoderma and antiretroviral treatment for human immunodeficiency virus infection: Not just a coincidence

摘要

A 49-year-old woman presented with an 18-month history of a linear palmar hyperkeratotic rash. The patient was of West African origin. She had no history of any similar condition or of any other dermatological conditions. There was no family history and all the patient's relatives were well, with no particular skin complaints. A few months before the onset of the rash, the patient had undergone a routine blood test as part of a job application, and this blood test had revealed a low lymphocyte count. Further blood tests confirmed that the patient was infected with HIV, and she was started on antiretroviral drugs. No other problems were recorded; in particular, the results of viral hepatitis and syphilis serology tests were negative. The patient's initial treatment included a combination of zidovudine, lamivudine (both nucleoside analogue reverse transcriptase inhibitors; NRTIs) and efavirenz (a non-nucleoside analogue reverse transcriptase inhibitor; NNRTI), which were well tolerated and successful in re-establishing a normal lymphocyte count.