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April 1997

Dramatic Cutaneous Psoriasis Improvement in a Patient With the Human Immunodeficiency Virus Treated With 2',3'-Dideoxycytidine and Ritonavir

Author Affiliations

CHU de Saint-Etienne Hopital de Bellevue 42055 Saint-Etienne Cedex 2, France


Arch Dermatol. 1997;133(4):531. doi:10.1001/archderm.1997.03890400137028

Psoriasis is particularly severe and difficult to treat using conventional therapy in patients with the human immunodeficiency virus (HIV).1 Zidovudine has already been shown to be of benefit for the treatment of psoriasis in patients with HIV,2 but to our knowledge, no other antiretroviral agent has been reported to have this particular activity. We describe a 43-year-old intravenous drug abuser who since 1986 developed severe psoriasis involving 6 sites (face, umbilicus, fingers and nails, elbows, buttocks, and knees), with a global body surface area of 20%, accompanied by painful arthritis involving the wrists, fingers, and ankles. The diagnosis of psoriasis was made by a dermatologist and confirmed on a skin biopsy specimen with fungal stain. At that time the patient's HIV-positive status was discovered (enzyme-linked immunosorbent assay and Western blot technique).

Despite treatment with methotrexate (7.5 mg/wk for 1 month), which was rapidly discontinued because of patient intolerance,