Chronic Verrucous Varicella-Zoster Virus Infection in Patients with the Acquired Immunodeficiency Syndrome (AIDS)

LeBoit, Philip E.; Lı́mová, Markéta; Yen, T. S. Benedict; Palefsky, Joel M.; White, Clifton R.; Berger, Timothy G.

doi:10.1097/00000372-199202000-00001

Cited by 71 publications

(43 citation statements)

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“…14,37 In this context, it is well known that cutaneous herpes infections can present with atypical clinical features in patients with immunosuppression or with underlying hematologic diseases. 2,22,23 In these instances, the clinical diagnosis may be problematic, and the differential diagnosis includes cutaneous lymphoma or pseudolymphoma among others. In addition, histology of cutaneous herpes infections can vary to a great extent, ranging from lesions with purely epithelial involvement and sparse to absent inflammatory infiltrates, to cases with a florid pseudolymphomatous pattern simulating a malignant lymphoma.…”

mentioning

confidence: 99%

Histopathologic Features of Cutaneous Herpes Virus Infections (Herpes Simplex, Herpes Varicella/Zoster)

Leinweber

Kerl

Cerroni

2006

The American Journal of Surgical Pathology

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Cutaneous eruptions caused by herpes simplex 1/2 (HSV-1/2) and herpes varicella/zoster (VZV) represent common dermatoses. In some cases, they present with atypical clinical and/or histopathologic features, including presence of dense lymphoid infiltrates with atypical lymphocytes simulating cutaneous lymphomas. In this study, we reviewed the biopsy specimens of 65 patients (33 males, 32 females; mean age, 61.2 years; median age, 62 years; age range, 19-96 years) with cutaneous eruptions caused by HSV-1/2 or VZV. Histologic examination revealed several atypical findings, including presence of dense lymphoid infiltrates, angiotropism, and atypical lymphocytes simulating malignant lymphoma. Immunohistochemistry performed in 22 cases showed a predominant T-cell infiltrate, in the majority of cases with variable numbers of CD30+ and CD56+ cells. Two cases with a pseudolymphomatous appearance and small clusters of CD30+ cells revealed a monoclonal population of T lymphocytes by PCR analysis, underlying the difficulties in classifying some of these cases correctly. Our study indicates that cutaneous herpes infections can exhibit several atypical histopathologic, immunohistochemical, and molecular features, and that in given cases accurate clinicopathologic correlation and short-term follow-up controls are necessary for differentiation from cutaneous lymphomas.

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confidence: 99%

Histopathologic Features of Cutaneous Herpes Virus Infections (Herpes Simplex, Herpes Varicella/Zoster)

Leinweber

Kerl

Cerroni

2006

The American Journal of Surgical Pathology

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“…The warty clinical appearance of these lesions correlates with the pathological findings of massive hyperkeratosis, acanthosis and herpetic cytopathic changes [24]. These lesions may reflect a chronic manifestation of the VZV infection [19,24]. Although the presence of other agents, (such as Candida albicans, Pityrosporum and Mycobacterium ai^iMm-complex) has been reported in the lesions in some cases [9,19,20], this is probably coincidental.…”

Section: Discussionmentioning

confidence: 72%

“…In these patients, especially in advanced stages of the disease, atypical persistent forms of VZV infection have been described . One of these atypical patterns consists of hyperkeratotic verrucous papules [7][8][9][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The warty clinical appearance of these lesions correlates with the pathological findings of massive hyperkeratosis, acanthosis and herpetic cytopathic changes [24].…”

Section: Discussionmentioning

confidence: 99%

Atypical herpes zoster in a patient with AIDS

Fernández-Díaz

Herranz

Lucas

et al. 1995

Acad Dermatol Venereol

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Objective To report a case of persistent infection by varicella-zoster virus (VZV) in an HIV-infected patient who presented with atypical, hyperkeratotic viral lesions and a partial response to acyclovir.Methods Viral changes found on histopathological examination; definitive diagnosis of VZV infection was established by viral culture.Results Lesions of chronic hyperkeratotic herpes zoster responded partially to acyclovir therapy, and complete resolution was achieved with intravenous foscamet. Absence of visceral involvement.Conclusion Prolonged acyclovir therapy for herpes virus infections in HIV-seropositive patients may represent an important pathogenic factor for the appearance of atypical clinical forms associated with drug-resistant viral strains.

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“…Verrucous skin lesions in HIV have been attributed to VZV, HSV and CMV, In their study of six patients with verrucous VZV infection and AIDS, LE BOlT et al [18] concluded that polymerase chain reaction studies should be a standard investigation to clarify the presence or absence of particular viruses, as they contend that HSV and CMV do not produce verrucous lesions. Chronic verrucous or eczematous VZV is seen almost exclusively in HIV disease, and it may occur after primary infection or reactivation.…”

Section: Herpesvirusmentioning

confidence: 99%

Skin Diseases Associated with HIV Infection

Innocenzi

2001

Current Topics in Pathology

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Chronic Verrucous Varicella-Zoster Virus Infection in Patients with the Acquired Immunodeficiency Syndrome (AIDS)

Cited by 71 publications

References 0 publications

Histopathologic Features of Cutaneous Herpes Virus Infections (Herpes Simplex, Herpes Varicella/Zoster)

Histopathologic Features of Cutaneous Herpes Virus Infections (Herpes Simplex, Herpes Varicella/Zoster)

Atypical herpes zoster in a patient with AIDS

Skin Diseases Associated with HIV Infection

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