AZCO MINING -- BANK SYNDICATE COMMITS $US35-MILLION TO FUND CONSTRUCTION OF AZCO'S SANCHEZ MINE; PROJECT FINANCING COMMITMENTS TOTAL $US70-MILLION.

VANCOUVER, British Columbia--(BUSINESS WIRE)--Nov. 16, 1994-- AZCO Mining Inc. is pleased to announce it has received a formal commitment from a syndicate of international banks led by Barclays Bank PLC, and including Credit Suisse and Bayerische Vereinsbank AG, for a $US35-million Credit Facility to fund the construction of the company's Sanchez Mine in Arizona.

As part of the overall project financing, Barclays has also provided an additional $US20-million credit line to the company which may be used in support of a copper hedging program.

As a requirement of the project financing package, the company has arranged up to $US15-million of lease financing to fund the capital expenditure for heavy equipment with Caterpillar Financial Services Corp., a subsidiary of Caterpillar Inc., and others.

The syndicated debt package and the combined new commitments totalling $US70-million as detailed above, are viewed as significant by the company because they pave the way for AZCO to complete project financing and commence construction at the Sanchez in early 1995.

The loan, which is in final documentation, incorporates certain conditions precedent to drawdown. These include, inter alia, a requirement for a hedging program; a debt reserve fund; and other required equity contributions.

On behalf of the board of directors of AZCO Mining Inc.

Alan P. Lindsay

Chairman and Chief Executive Officer

This news release has been prepared by management of the company who takes full responsibility for its contents. The American Stock Exchange and the Toronto Stock Exchange neither approve nor disapprove the contents of this news release.

This news release shall not constitute an offer to sell or the solicitation of an offer to buy, nor shall there be any sale of these securities in any jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such jurisdiction.

    CONTACT:  North America:
              Alan Lindsay/Anthony R. Harvey, (1) 800-563-SXEW
(7939)
                             or
              Europe:
              Andrew Malim, (44) 71 924 2266

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Systemic interferon alfa-2b has resulted in temporary remission in 30% of cases.8

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Sun-related neoplasms such as squamous cell carcinoma have been seen in HIV-infected patients11

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(figure 12). Cutaneous lymphoma is rare but, when present, is usually a B-cell type, such as Burkitt's lymphoma. The latter is a poor prognostic sign, and affected patients usually live less than 1 year.8

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OTHER CONDITIONS--Psoriasis affects 1% to 2% of the general population and 5% of HIV-infected persons. New onset of psoriasis, especially in patients over the age of 30 years, should arouse suspicion of HIV infection. New onset of psoriasis in patients wit h known HIV infection is often a harbinger of AIDS. These patients have a poor prognosis.3 (Reference)

Arthritis occurs in 30% of HIV-infected persons with psoriasis, in contrast to 5% of persons with psoriasis but without HIV.8 (Reference) Methotrexate (Rheumatrex Dose Pack) should not be used in immunocompromised persons, and some investigators advocate testing for HIV infection before using the drug. Treatment with zidovudine has at times relieved psoriasis.1

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Reiter's syndrome, a disease of young men that may present simultaneously with symptoms of HIV infection, manifests with arthritis, conjunctivitis, and urethritis. Pustules that form keratotic papules may develop on the palms and soles. When the soles become diffusely thickened and scaled, the condition is called keratoderma blennorrhagicum. The nails also may be involved. Plaques resembling seborrheic dermatitis and psoriasis may present in the groin and axillae, and a circinate balanitis may develop. Some patients have geographic tongue. Treatment includes topical corticosteroids, anthralin (Anthra-Derm, Lasan), and ultraviolet light. Etretinate (Tegison) has been used in severely affected patients.12

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Drug reactions are extremely common in HIV-infected patients. These range from urticaria to exfoliative erythroderma, fixed drug eruptions, erythema multiforme, and toxic epidermal necrolysis. A skin rash develops in 48% of HIV-infected persons taking trimethoprim-sulfamethoxazole (Bactrim, Cotrim, Septra), the drug of choice for treatment and prophylaxis of Pneumocystis carinii pneumonia (PCP). In persons receiving therapeutic doses for PCP, the incidence of drug reaction is increased tenfold over that in the non-HI V-infected population.1

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An interesting phenomenon that has been seen with the use of zidovudine has been discoloration of the nails (figure 13), lateral tongue, and lateral abdomen. Discoloration tends to occur in persons with dark skin and is caused by deposition of melanin in the tissue. The condition is dose-dependent, and the color fades when zidovudine is discontinued.13

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Other drugs commonly used for HIV infection that have caused cutaneous reactions are dapsone, ketoconazole, pyrimethamine (Daraprim), amphotericin B (Fungizone), and pentamidine isethionate (NebuPent, Pentam 300).

Dry skin, or xerosis, is common and bothersome in patients with HIV infection and may lead to exfoliative dermatitis (figure 14), desquamation of the skin, and even ichthyosis. Ichthyosis can also be a sign of underlying lymphoma.9 (Reference) Xerosis can cause debilitating pruritus, as can the folliculitis described previously. Pruritus itself has been reported as an initial symptom of HIV infection.14 (Reference) Scabies is another cause of pruritus.

HIV infection can cause profound thrombocytopenia, and petechiae may develop. Thrombocytopenia is often one of the earlier manifestations of HIV infection.

Conclusions

As an increasing number of primary care physicians are called on to treat HIV-in fected patients, knowledge of the spectrum of mucocutaneous disorders common in HIV and how to treat them is essential. Empirical therapy is often a good way to start; if treatment fails, a biopsy is indicated.

Dermatologic disease in patients with HIV infection may be a sign of life-threatening or disseminated disease, or it may be just an uncomfortable or cosmetic nuisance. In either case, patients need accurate diagnosis and treatment to prevent complications and to help them look and feel as good as possible as they continue to live with their condition. PGM Supported by funding from the Health Resources and Services Administration, Public Health Service, US Department of Health and Human Services, Federal Training Grant Agreement No. BRT 000041. Address for correspondence: Donna E. Sweet, MD, University of Kansas School of Medicine--Wichita, 1010 N Kansas, Wichita, KS 67214.

REFERENCES:

1. Berger TG. Dermatologic manifestations of HIV infection. In: Cohen PT, Sande MA, Volberding PA, eds. The AIDS knowledge base: a textbook on HIV disease from the University of California, San Francisco, and the San Francisco General Hospital. Waltham, M ass: Medical Publishing Group, 1990:5.3.1

2. Jewell ME, Sweet DE. Asymptomatic HIV infection: a primary care disease. Post grad Med 1992;92(5):155-66

3. Kaplan MH, Sadick N, McNutt NS, et al. Dermatologic findings and manifestations of acquired immunodeficiency syndrome (AIDS). J Am Acad Dermatol 1987;16(3 Pt 1):485-506

4. Powderly WG. Mucosal candidiasis caused by non-albicans species of Candida in HIV-positive patients. (Letter) AIDS 1992;6(6):604-5

5. Katz MH, Greenspan D, Westenhouse J, et al. Progression to AIDS in HIV-infected homosexual and bisexual men with hairy leukoplakia and oral candidiasis. AIDS 1992;6(1):95-100

6. Masouredis CM, Katz MH, Greenspan D, et al. Prevalence of HIV-associated periodontitis and gingivitis in HIV-infected patients attending an AIDS clinic. J Acquir Immune Defic Syndr 1992;5(5):479-83

7. Berger TG, Obuch ML, Goldschmidt RH. Dermatologic manifestations of HIV infection. Am Fam Physician 1990;41(6):1729-42

8. Friedman-Kien AE, Harte JS. American Academy of Dermatology Symposium on AIDS. Atlanta, Georgia, Dec 1, 1990. J Am Acad Dermatol 1991;25(6 Pt 1):1086-91

9. Valle SL. Dermatologic findings related to human immunodeficiency virus infection in high-risk individuals. J Am Acad Dermatol 1987;17(6):951-61

10. Penneys NS, Hicks B. Unusual cutaneous lesions associated with acquired immunodeficiency syndrome. J Am Acad Dermatol 1985;13(5 Pt 1):845-52

11. de Boer WA, Danner SA. HIV infection and squamous cell carcinoma of sun-exposed skin. (Letter) AIDS 1990;4(1):91

12. Berger T. Dermatologic manifestations of HIV infection. AIDS Clin Care 1990;2(7):57-64

13. Greenberg RG, Berger TG. Nail and mucocutaneous hyperpigmentation with azidothymidine therapy. J Am Acad Dermatol 1990;22(2 Pt 2):327-30

14. Shapiro RS, Samorodin C, Hood AF. Pruritus as a presenting sign of acquired immunodeficiency syndrome. J Am Acad Dermatol 1987;16(5 Pt 2):1115-7

Table 1. Skin diseases diagnostic of AIDS

In patients with positive HIV test Coccidioidomycosis Histoplasmosis Kaposi's sarcoma at any age* Lesions due to Mycobacterium

tuberculosis Small, noncleaved lymphoma*

In patients without positive HIV test Cryptococcosis Mucocutaneous lesion due to

herpes simplex virus lasting

longer than 1 mo* Kaposi's sarcoma in patient

under 60 yr old*

*These lesions may occur in the mouth.

Table 2.

Oral and dermatologic conditions commonly seen with HIV infection Herpes zoster in patients under 50 yr old New-onset psoriasis in patients over 30 yr old Oral candidiasis Oral hairy leukoplakia Recalcitrant vaginal candidiasis New onset of common warts on hands, feet, and beard area in adult Sexually transmitted disease (ie, syphilis, gonorrhea, herpes simplex, chancroid, human papillomavirus) Molluscum contagiosum in adult Numerous nails with fungal infection, especially fingernails Pruritus Petechiae or idiopathic thrombocytopenic purpura Viral exanthem Kaposi's sarcoma