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An 8-year-old boy with perinatally acquired HIV infection was initiated on antiretroviral therapy (zidovudine, lamivudine and nevirapine) at a CD4 count of 270 cells/μL. Three months later, he noted bluish-black pigmentation of nails starting from the base and extending distally (figure 1), more prominent in the thumbnail (figure 2). There were no other symptoms and the examination …
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