Sexually transmitted infections: zidovudine nail pigmentation: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Sexually transmitted infections: zidovudine nail pigmentation

Sample item

A man with HIV on a zidovudine-containing regimen has developed blue-black longitudinal bands on several nails and a macrocytic anaemia. What is the likely cause of the nail change?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Zidovudine-induced melanonychia

Zidovudine causes pigmentation of the nails and macrocytosis. Multiple bands involving several nails after starting the drug are drug-induced rather than a melanoma.

Option by option

  • A. Subungual melanoma

    Subungual melanoma usually involves a single nail and a single widening band.

  • B. Fungal melanonychia

    Fungal melanonychia involves a single nail and is not linked to macrocytosis.

  • C. Nail psoriasis

    Nail psoriasis gives pitting and onycholysis, not pigmented bands.

  • D. Zidovudine-induced melanonychia (correct)

    Correct. Zidovudine produces multiple pigmented bands and macrocytosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Zidovudine-induced melanonychia. Zidovudine causes pigmentation of the nails and macrocytosis.

Why is "Subungual melanoma" not the answer?

Subungual melanoma usually involves a single nail and a single widening band.

Why is "Fungal melanonychia" not the answer?

Fungal melanonychia involves a single nail and is not linked to macrocytosis.

Why is "Nail psoriasis" not the answer?

Nail psoriasis gives pitting and onycholysis, not pigmented bands.

What concept does this question test?

It tests Sexually transmitted infections: zidovudine nail pigmentation in Dermatology. Multiple bands involving several nails after starting the drug are drug-induced rather than a melanoma.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Sexually transmitted infections: zidovudine nail pigmentation?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.