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. All HIV-positive patients attending outpatient departments (OPDs) and admitted as inpatients during the above period were included in the study. Initial screening for HIV was done by the rapid test and, if positive, was confirmed by two different types of enzyme-linked immunosorbent assay (ELISA). Patients already on anti-retroviral therapy (ART) were not included. Age, weight, probable time of first high-risk behaviour and CD4+ counts were noted. A complete medical history and physical examination of patients was carried out for optimal evaluation and diagnosis of dermatological and venereological lesions. The diagnosis was based on clinical criteria in most of the cases. Appropriate laboratory tests like scraping for fungus/candida, culture, skin biopsy, Cutaneous manifestations of HIV-a detailed study of morphological variants, markers of advanced disease, and the changing spectrum RESULTSInfections were the most common group of mucocutaneous manifestations, while onychomycosis was the commonly observed individual manifestation. A different set of cutaneous markers for advanced HIV disease was observed and new parameters for therapy were also arrived at. MJAFI 2012;68:20-27 CONCLUSION

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A 26-year-old male who presented to the dermatology OPD with complaints of a swelling on his lip of 6 months′ duration was on examination found to have a solitary ulcerated nodule over the lip and an enlarged submental lymph node. Skin smear and biopsy from the lesion did not yield the diagnosis. Needle aspiration from the draining lymph node revealed the diagnostic Leishman-Donovan bodies. The patient responded to treatment with a combination of oral ketoconazole and intralesional sodium stibogluconate. We report this case because of both the unusual location of the lesion and the unusual method of diagnosis and treatment.

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Context:Literature is replete with studies on zidovudine-induced myopathy after prolonged use (use beyond 270 days on an average). However, all these studies have been done on patients of Caucasian, American and African ethnic origin. No such study has been carried out in Indian patients to our knowledge.Aims:To determine the correlation of zidovudine usage with serum creatine phosphokinase (CK) levels, clinical muscular weakness and muscle histology in Indian patients, we studied 147 physically active, Human Immunodeficiency Virus infected men on prolonged zidovudine-based antiretroviral therapy (ART).Settings and Design:Cross-sectional study on hospital follow-up patients of HIV infection.Materials and Methods:All cases on ART who reported to our canter during a period of 18 months were evaluated for symptoms (muscle fatigue, myalgia), objective muscle strength (testing clinically) and serum CK levels, and a select group was evaluated by muscle biopsy. These patients were on zidovudine for 1 to 7 years.Results:None of the patients studied had significant symptoms or objective muscle weakness and only a small fraction (10.8% of cases) had marginally raised serum CK levels. All muscle biopsies were normal on light microscopy.Conclusions:Zidovudine myopathy may be a constraint for use of the drug in the western population; however, it is a well-tolerated drug as regards myopathy in our study on Indian patients.

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