Acquired Lymphedema of the Hand Due to Herpes Simplex Virus Type 2

Butler, David F.; Malouf, Peter J.; Batz, Richard C.; Stetson, Cloyce L.

doi:10.1001/archderm.135.9.1125

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…As a matter of fact, all three conditions (RCL, HIS, ODA) lead to a hindrance of lymph circulation, which is obvious in RCL and more or less overt (but it certainly exists) in HIS and ODA. As concerns HIS, recurrent herpetic infections have been reported amongst the infective causes of secondary lymphoedema, 99 along with erysipelas, lymphogranuloma inguinale and tuberculosis (Table 1). This does not apply to herpes zoster infection, which, however, is known to cause the destruction of Ad and C nerve fibres in the mid-and lower dermis.…”

Section: Discussionmentioning

confidence: 99%

The immunocompromised district: a unifying concept for lymphoedematous, herpes‐infected and otherwise damaged sites

Ruocco¹,

Brunetti

Puca

et al. 2009

Acad Dermatol Venereol

203

275

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Systemic immunodeficiency is known to facilitate the onset of opportunistic infections, tumours and immune disorders in any district of the body. There are clinical events, such as chronic lymphoedema, herpetic infections, vaccinations and heterogeneous physical injuries which can selectively damage and immunologically mark the cutaneous district they act upon. After the causing event has disappeared, the affected district may appear clinically normal, but its immune behaviour is often compromised forever. An immunocompromised district becomes a site which is particularly susceptible to subsequent outbreaks of opportunistic infections, tumours and immune disorders confined to the district itself. In this review, there is an ample case-report collection of opportunistic disorders (infectious, neoplastic, immune) which appeared in immunocompromised districts. The cases have been grouped according to the clinical settings responsible for the local immune imbalance: regional chronic lymphoedema; herpes-infected sites, which feature the well-known Wolf's isotopic response; and otherwise damaged areas, comprising sites of vaccination, ionizing or UV radiation, thermal burns and traumas. Whatever the immunocompromising factor, a common denominator which facilitates the occurrence of tumours, infections and dysimmune reactions in an immunocompromised district may reside in locally hampered lymph drainage and/or locally altered neuromediator signalling. In fact, any obstacle to the normal trafficking of immunocompetent cells through lymphatic channels or any interference with the signals that the neuropeptides and neurotransmitters released by peripheral nerves send to cell membrane receptors of immunocompetent cells, can significantly alter the local immune response, thus paving the way for heterogeneous opportunistic disorders in the immunocompromised district.

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Section: Discussionmentioning

confidence: 99%

The immunocompromised district: a unifying concept for lymphoedematous, herpes‐infected and otherwise damaged sites

Ruocco¹,

Brunetti

Puca

et al. 2009

Acad Dermatol Venereol

203

275

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“…In the past, failure to do so has led to many instances of surgical intervention for presumed bacterial infection, unnecessary hospitalizations, anxiety and parenteral antibiotic administration 13,15 , 16,18 . In this case report, not only was the patient exposed to multiple courses of antibiotics but antiviral therapy was also delayed that, if given promptly, might have prevented the development of persistent lymphoedema 17 …”

Section: Discussionmentioning

confidence: 83%

“…Although lymphatic complications of herpetic hand infections such as oedema and erythematous streaking of the forearm with lymphadenopathy are well described, persistent acquired lymphoedema of the hand and forearm is very rare 14–16 . In one case the persistent lymphoedema was attributed to be the result of repeated episodes of untreated HSV‐2 infection, 17 and to the best of our knowledge, is the first description of persistent acquired lymphoedema that has occurred in isolation from other more common lymphatic complications, including lymphangitis and lymphadenopathy.…”

Section: Discussionmentioning

confidence: 99%

Recurrent herpes simplex virus type 2 infection of the hand complicated by persistent lymphoedema

Fletcher

Sterling

2005

Aust J Dermatology

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A 33-year-old, immunocompetent woman had recurrent herpes simplex virus reactivation of the right hand presenting with a cellulitis-like picture. She continued to have monthly debilitating recrudescences for more than 3 years until an adequate dosage of prophylactic antiviral therapy was achieved. After 2 years of repeated episodes she had chronic dull pain and developed persistent acquired lymphoedema of the left hand and forearm, which is an extremely rare complication. This case highlights the need for herpes simplex infection of the hand to be included in the differential diagnosis of bacterial cellulitis in order for appropriate and prompt therapy to be achieved.

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“…181 Acute skin eruptions that are positive for HSV DNA polymerase are an increasing problem in patients who undergo stem cell transplantation. 188 Special clinical variants 189 include herpes folliculitis of the beard or scalp, herpetic whitlow [190][191][192][193] (usually in medical or nursing personnel), necrotizing and ulcerative balanitis 194,195 and vulvitis 196 (a very rare HSV-2 complication, often associated with HIV infection), a varicella-like eruption, 197 infection localized to sites of atopic dermatitis, 198 pulsed-dye laser treatment, 199 or photoexposure, 200 vegetating plaques, 201,202 hypertrophic papulonodules, 203 flaccid intracorneal blisters, 204 acquired lymphedema of the hand, 205 and eczema herpeticum (see p. 616). 183 Prostaglandins and diminished production of IFN-γ may play a role in the reactivation of infections.…”

Section: Electron Microscopymentioning

confidence: 99%

Viral diseases

Weedon

2010

Weedon's Skin Pathology

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Acquired Lymphedema of the Hand Due to Herpes Simplex Virus Type 2

Cited by 8 publications

References 5 publications

The immunocompromised district: a unifying concept for lymphoedematous, herpes‐infected and otherwise damaged sites

The immunocompromised district: a unifying concept for lymphoedematous, herpes‐infected and otherwise damaged sites

Recurrent herpes simplex virus type 2 infection of the hand complicated by persistent lymphoedema

Viral diseases

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