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Atripla and darkening of lower legs
Apr 6, 2011

Dear Dr Henry

I have been on Atripla for nearly a year and I have noticed a significant darkening of the skin on the tops of my toes, feet and ankles - almost like a severe case of sunburn. It started out as a kind of petechial rash and has now just manifested in noticeable darkness - no more red spots.

I have read that darkening of the palms of your hands and soles of your feet are a common side-effect of Atripla but that does not seem to explain the darkening on my feet.

Is there anything I can use/do to minimise this? Could it just be a case of extreme photosensitivity in these areas? I have started using a factor 40 sunburn cream when I wear open shoes but it has not improved.

My VL is undetectable (has been since I started HAART) and I am not experiencing any other side-effects.

Thanks for your help!

Response from Dr. Henry

I have not observed nor heard of a localize darkening of the feet as you describe in the setting of Atripla treatment. Some conditions related to diabetes, vascular insufficiency, or fungal infections may localize to that area--you may want to see a dermatologist to try to pin down the diagnosis. KH

A positive story about Atripla (specifically sustiva/efavirenz) rash

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