#pearls topic is HIV.

1-Most common pathogen to cause onychomycosis…..T.ruburm

Treatment of fungal infection… Same as in Non HIV. Oral terbinafine is safe.

2-Stain used for cutaneous histoplasmosis is Gomori methenamine silver stain

Stain used for systemic histoplasmosis is wright stain.

3-Cryptococcal infection …stain used is mucicaramine or tznack smear

Poor progsis if CNS involvement .

4-Leishmaniasis is difficult to treat compared to the one in normal person.it is associated with rheumatoid nodulosis.

5-Crusted scabies may b localized to sole or genitalia. On histo , eccrine ductal and follicular mucinosis can be seen.

6-kaposi sarcoma,a spindle cell tumor,risk increase if topical tacrolimus used in HIV.In children or non HIV person transmission is by saliva.

7-ratio of SCC:BCC 1:7

8- long term voriconazole therapy ,associated with multiple BCC.

9-melanoma ,a non AIDS defining cancer, has poor prognosis if CD4 count is low

10-most common BCC is superficial spreading type,treated with topical imiquimod

11- hodgkin disease with mixed cellularity and lymphocyte depleted ,more common in HIV.

12-most common lymphoma is NHL.

13 T.ruburm ,most common cause of onychomycosis

14- grey nail seen at CD4 count< 200 ×10⁶/L.

15-Oral hyperpigmentation is sign of low CD4 count (<200) .

16-If pt has hairy cell leukemia, 75% chance to develop AIDS with in 2 to 3 years.

17-concrum oris(noma), seen in malnourished HIV infected children.

18- hydroxyurea , cause melanonychia.

19- indinavir and zidovudine cause hair and nail pigmentation

20- foscarnet … side effect :Penile ulceration and eosinophilic folliculitis