Acquired Immunodeficiency Syndrome

Flagrant, recalcitrant fungal infections of the nails, a destructive, almost granulomatous-like psoriatic involvement of the nails, melanonychia striata (sometimes with a pseudo-Hutchinson's sign and seen with or without antiretroviral treatment), proximal or total leukonychia, Beau's lines, clubbing, onychoschizia, brittle nails, yellow nails, blue nails, small lunulae, periungual erythema, and squamous cell carcinoma of the nail bed have all been associated with HIV infection.

In particular, onychomycosis that involves the proximal nail plate, most nails (rather than a few nails), and infections with saprophytic fungi should make one suspicious of HIV infection.

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