Zidovudine-Induced Nail Pigmentation

To the Editor.— Zidovudine (azidothymidine, AZT, or Retrovir) is widely used in the treatment of patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS-related complex. 1 Side effects, however, are frequent and a number of them are still to be identified. 2 Recently, two articles about patients with nail pigmentation associated with the administration of zidovudine have appeared. 3,4 We now report two similar cases. Report of Cases.— Case1.—A 25-year-old white man with the human immunodeficiency virus (HIV) developed Pneumocystis carinii pneumonia. He was a parenteral drug addict. In May 1987, therapy with zidovudine (500 mg every six hours during the first month of treatment, followed by 250 mg every six hours) was begun. His only concomitant medication was administration of a placebo or acyclovir as a part of a double-blind clinical trial. Six months later, longitudinal pigmented bands developed in all fingernails. His toenails were spared. Physical