Clinical, Pathologic, and Immunologic Features of Human T-Lymphotrophic Virus Type I–Associated Infective Dermatitis in Children

Grenade, Lois La; Manns, Angela; Fletcher, Valerie; Carberry, C.A.; Hanchard, B; Maloney, Elizabeth M.; Cranston, Beverly; Williams, Nadia P.; Wilks, Rainford; Kang, Eric Choo; Blattner, William A.

doi:10.1001/archderm.134.4.439

Cited by 138 publications

(157 citation statements)

References 17 publications

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“…Emphasis should be given to the differential diagnosis with atopic and seborrheic dermatitis. In atopic dermatitis, the distribution and morphological aspects of the lesions are similar to those seen for ID, in which the infection is more evident, with exudation and fetid odor (43). Conversely, in seborrheic dermatitis, the lesions are erythematous and scaly.…”

Section: Dermatological Conditions Associated With Htlv-1mentioning

confidence: 60%

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Epidemiology, Treatment, and Prevention of Human T-Cell Leukemia Virus Type 1-Associated Diseases

Gonçalves

Proietti

Ribas³

et al. 2010

Clin Microbiol Rev

395

321

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SUMMARYHuman T-cell leukemia virus type 1 (HTLV-1), the first human retrovirus to be discovered, is present in diverse regions of the world, where its infection is usually neglected in health care settings and by public health authorities. Since it is usually asymptomatic in the beginning of the infection and disease typically manifests later in life, silent transmission occurs, which is associated with sexual relations, breastfeeding, and blood transfusions. There are no prospects of vaccines, and screening of blood banks and in prenatal care settings is not universal. Therefore, its transmission is active in many areas such as parts of Africa, South and Central America, the Caribbean region, Asia, and Melanesia. It causes serious diseases in humans, including adult T-cell leukemia/lymphoma (ATL) and an incapacitating neurological disease (HTLV-associated myelopathy/tropical spastic paraparesis [HAM/TSP]) besides other afflictions such as uveitis, rheumatic syndromes, and predisposition to helminthic and bacterial infections, among others. These diseases are not curable as yet, and current treatments as well as new perspectives are discussed in the present review.

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Section: Dermatological Conditions Associated With Htlv-1mentioning

confidence: 60%

“…It occurs predominantly during childhood (76). Laboratory parameters such as the erythrocyte sedimentation rate, immunoglobulin level, CD4 and CD8 cell counts, and CD4/CD8 ratio, when elevated, must be considered when evaluating a patient with suspected ID, along with positivity for HTLV-1 (43).…”

Section: Dermatological Conditions Associated With Htlv-1mentioning

confidence: 99%

Epidemiology, Treatment, and Prevention of Human T-Cell Leukemia Virus Type 1-Associated Diseases

Gonçalves

Proietti

Ribas³

et al. 2010

Clin Microbiol Rev

395

321

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“…Os principais diagnósticos diferenciais são a dermatite seborréica e o eczema atópico 56 . La Grenade e colaboradores propuseram critérios diagnósticos para a dermatite infecciosa, dividindo-os em maiores e menores 55 . Para se definir um caso são necessários quatro dos cinco critérios maiores, sendo obrigatórios os critérios "1", "2" e "3".…”

Section: -Dermatite Infecciosa (Di)unclassified

“…Corticoesteróides tópicos de leve potência, anti-histamínicos orais e xampus ceratolíticos para o couro cabeludo também são indicados. Não se utiliza terapia antiviral ou imunomoduladora 55 .…”

Section: -Dermatite Infecciosa (Di)unclassified

Lesões dermatológicas em pacientes infectados pelo vírus linfotrópico humano de células T do tipo 1 (HTLV-1)

Nobre

Guedes

Proietti

et al. 2005

Rev. Soc. Bras. Med. Trop.

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RESUMO O vírus linfotrópico humano de células T do tipo 1 (HTLV-1) é o primeiro retrovírus isolado do ser humano. Descreveuse, em pouco tempo, o seu papel etiológico em algumas doenças, com destaque para a leucemia/linfoma de células T do adulto (ATLL), a mielopatia associada ao HTLV-1/paraparesia espástica tropical (HAM/TSP) e a uveíte associada ao HTLV-1 (HAU). Na década de 90, o HTLV-1 foi associado a eczema grave da infância, conhecido como dermatite infecciosa (DI). Desde então, diversos outros tipos de lesões cutâneas têm sido observados em pacientes infectados pelo HTLV-1, em especial, nos doentes de HAM/TSP ou de ATLL. Porém, mesmo portadores assintomáticos do vírus apresentam doenças dermatológicas. Excetuando-se a dermatite infecciosa, não há lesão da pele específica da infecção pelo HTLV-1. Aqui, os autores apresentam as principais lesões dermatológicas descritas em pacientes infectados pelo HTLV-1, destacando o valor epidemiológico e clínico desses achados. Palavras-chaves: HTLV-1. Retrovírus. ATLL. HAM/TSP. Lesões dermatológicas. Pele. ABSTRACT Human T-cell Lymphotropic vírus type I (HTLV-1) was the first human retrovírus described. Some time after its discovery a group of diseases were related to this vírus, such as, adult T-cell leukemia lymphoma (ATLL), HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and HTLV-1 associated uveitis (HAU). In the nineties, HTLV-1 was associated to a severe eczema of children, called infective dermatitis (ID

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“…Afecta, principalmente, a niños sobre dos años de edad, aunque también se ha descrito en adultos, sin diferencias por sexo. En áreas endémicas, se describió, para esta forma clínica, una seroprevalencia en la población infantil de 1% entre niños de 1 a 9 años, aumentando a 1,44% entre los 10 y 19 años 21 . Se caracteriza por la presencia de placas eritematosas, exudativas, costrosas, que comprometen intensamente el cuero cabelludo, oído externo, las regiones retroauricular y perinasal, párpados, cuello, axilas e ingles; se asocia a rinitis abundante y a una Caso Clínico El diagnóstico requiere de cuatro criterios mayores, siendo obligatorios los criterios 1º, 2º y 5º Del criterio 1º se necesita el compromiso de al menos 2 de los sitios enunciados erupción papular generalizada.…”

Section: Discussionunclassified

Eritrodermia exfoliativa y dermatitis infecciosa en un lactante infectado por el virus linfotrópico humano-I (HTLV-I)

C¹,

B²,

J³

et al. 2007

Rev. chil. infectol.

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Eritrodermia exfoliativa y dermatitis infecciosa en un lactante infectado por el virus linfotrópico humano-I (HTLV-I)Lilian Pérez C., Julia Villarroel B., Alejandra Reyes J., Alicia Benavides M. y Carla Muñoz O. Exfoliative erythroderma and infective dermatitis in an infant infected with human T-lymphotropic virus type I (HTLV I)We report a HTLV-I positive infant, whose infection was confirmed by polymerase chain reaction. The infant presented with an acute, severe, generalized eczema, exfoliation and severe erythroderma that yielded to an acute proteic malnutrition and frequent staphyloccocal infections, unresponsive to treatment, since the second month of life. Immunodeficiencies from other origin and other causes of erythroderma were ruled out. The histopathology studies and clinical course yielded to the diagnosis of infective dermatitis associated to HTLV-I. A review of the literature is performed.Key words: Human T-cell lymphotropic virus-I, infective dermatitis, erythroderma. Palabras claves: Virus linfotrópico de células T-humano tipo I, dermatitis infecciosa, eritodermia. Caso clínicoLactante de sexo masculino, nacido tras un embarazo controlado y parto vaginal, a las 38 semanas de gestación. Pesó 3.100 gramos y midió 49 cm. Recibió lactancia materna y alimentación artificial desde los primeros días de vida. Ambos padres eran aparentemente sanos, sin antecedentes de consanguinidad.Al mes de vida aparecieron en forma paulatina pápulas eritematosas en el mentón y en la zona retroauricular, extendiéndose progresivamente al resto de la cara, cuello, axilas e ingles, por lo cual consultó en Dermatología del Hospital Félix Bulnes C a los dos meses y medio de edad. Una primera biopsia de piel fue sugerente de una dermatitis seborreica. En las semanas subsiguientes empeoró su cuadro cutáneo, con diseminación de las lesiones a toda la superficie corporal, incluyendo palmas y plantas, con exudación intensa y especial predilección por las zonas cervical, retroauricular y cuero cabelludo, sin compromiso de mucosas, con pérdida difusa del pelo, poliadenopatías y rinorrea serosa (Figura 1). Dada la gravedad y extensión de las lesiones cutáneas, se hospitalizó con el diagnóstico de eritrodermia exfoliativa en estudio, planteándose una probable inmunodeficiencia. Introduccióna infección por HTLV-I existe en todo el mundo. Se calcula que hay entre 15 y 20 millones de personas infectadas en el planeta; sin embargo, sólo entre 1 y 5% de ellos desarrolla alguna patología. Su distribución es variable, con zonas de alta prevalencia como el sur de Japón (30%) y otras como Europa y Norteamérica, con cifras menores a 1% 1 .Como otros retrovirus, su forma de transmisión es por contacto sexual, vía transfusional o vertical. La vía transfusional es muy "eficiente", con seroconversión en 40 a 60% de los expuestos en un período de 60 días. Los niños adquieren la infección, fundamentalmente, a través de la leche materna, a diferencia de lo conocido para la infección por VIH 2 .En Chile, ha sido estudiado en diferentes grupos, encont...

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Clinical, Pathologic, and Immunologic Features of Human T-Lymphotrophic Virus Type I–Associated Infective Dermatitis in Children

Cited by 138 publications

References 17 publications

Epidemiology, Treatment, and Prevention of Human T-Cell Leukemia Virus Type 1-Associated Diseases

Epidemiology, Treatment, and Prevention of Human T-Cell Leukemia Virus Type 1-Associated Diseases

Lesões dermatológicas em pacientes infectados pelo vírus linfotrópico humano de células T do tipo 1 (HTLV-1)

Eritrodermia exfoliativa y dermatitis infecciosa en un lactante infectado por el virus linfotrópico humano-I (HTLV-I)

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