Detection of Epstein-Barr Virus in Epidermal Skin Lesions of an Immunocompromised Patient

Fermand, Jean‐Paul; Gozlan, Joël; Bendelac, Albert; Delauche-Cavallier, Marie-Christine; Brouet, Jean‐Claude; Morinet, F.

doi:10.7326/0003-4819-112-7-511

Cited by 37 publications

(11 citation statements)

References 23 publications

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“…EBV-DNA was detected in frozen material by Southern blot analysis using a randomly primed 32 P-labeled probe specific for the BamHI W internal repeats of the virus, in situ hybridization with EBV-specific probes, 54 PCR analysis, 55 or any combination thereof. Specific antibodies (IgG and IgM isotypes) against EBV (viral capsid antigen, early antigen, EBV nuclear antigen) in organ transplant recipients were detected by an ELISA assay.…”

Section: Virologic Investigationsmentioning

confidence: 99%

Treatment of B-lymphoproliferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients: a multicenter phase 1-2 clinical trial

Haddad

Paczesny

Leblond

et al. 2001

Blood

124

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Severe T-cell immunodeficiency after solid organ or bone marrow transplantation may result in the uncontrolled outgrowth of latently Epstein-Barr virus-infected B cells, leading to B-lymphoproliferative disorder (BLPD). Given the potentially important pathogenic role of IL-6 in BLPD, it was tested whether the in vivo neutralization of IL-6 by a monoclonal anti-IL-6 antibody could contribute to the control of BLPD. Safety and efficacy were assessed in 12 recipients of transplanted organs who had BLPD refractory to the reduction of immunosuppression over 8 days. Five patients received 0.4 mg/kg per day. The next 7 patients received 0.8 mg/kg per day. Treatment was scheduled to last 15 days. It was completed in 10 patients, and in the other 2 patients was discontinued early (days 10 and 13, respectively) because of disease progression. Treatment tolerance was good, and no major side effects were observed. High C-reactive protein levels were found in 9 patients before treatment but were normalized under treatment in all patients, demonstrating efficient IL-6 neutralization. Complete remission (CR) was observed in 5 patients and partial remission (PR) in 3 patients. Relapse was observed in 1 of these 8 patients in whom remission was observed. This relapse was unresponsive to treatment. Disease was stable in 1 patient, but it progressed in 3 patients. Seven patients are alive and well. Two patients died because of disease progression, and 3 patients died while in CR (chronic rejection in 2 patients and BLPD sequelae in 1 patient). These data suggest that the anti-IL-6 antibody is safe and should be further explored in the treatment of BLPD. (Blood. 2001;97: 1590-1597)

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Section: Virologic Investigationsmentioning

confidence: 99%

Treatment of B-lymphoproliferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients: a multicenter phase 1-2 clinical trial

Haddad

Paczesny

Leblond

et al. 2001

Blood

124

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“…44,45 Rare photomicrographs of this eruption 45,46 show changes best interpreted as an acute vacuolar interface dermatitis (erythema multiforme (EM)-like with sparse infiltrates and rare necrotic keratinocytes 47 ) similar to that seen in exanthematous (morbilliform) drug eruptions; the inflammatory infiltrates in these published cases are significantly less cellular and do not exhibit the nuclear debris identified in our 2 cases. Although there was no evidence in our cases of cutaneous EBV infection, EBV DNA has been detected by in situ hybridization in keratinocytes from a patient with a widespread cutaneous eruption with EM-like histology and chronic lymphocytic leukemia.…”

Section: Discussionmentioning

confidence: 66%

“…Although there was no evidence in our cases of cutaneous EBV infection, EBV DNA has been detected by in situ hybridization in keratinocytes from a patient with a widespread cutaneous eruption with EM-like histology and chronic lymphocytic leukemia. 46 The host cellular immune response is crucial in limiting EBV infection; suppression of the cellular immune response leads to unabated EBV replication 42,43 and may explain the presence of detectable virus in the latter patient.…”

Section: Discussionmentioning

confidence: 99%

Adverse Antibiotic-Induced Eruptions Associated With Epstein Barr Virus Infection and Showing Kikuchi-Fujimoto Disease-Like Histology

Perlmutter¹,

Tobin²,

Richardson³

et al. 2006

The American Journal of Dermatopathology

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The antibiotic-induced eruption of infectious mononucleosis is a well-known clinical phenomenon. Latent viral infection with herpesviridae (eg, human herpes virus 6 (HHV-6) and Epstein-Barr virus (EBV)) is suspected to play a role in the drug hypersensitivity syndrome. The cutaneous pathologic findings have not been reported in the former, and are infrequently reported in the latter entity. Herein, we describe the biopsy findings of a cefprozil-induced rash in infectious mononucleosis and a minocycline-associated drug hypersensitivity syndrome. Biopsy of these exanthematous eruptions revealed an acute vacuolar interface superficial and deep perivascular and interstitial lymphocytic dermatitis. CD8(+) lymphocytes predominated and were associated with non-neutrophilic nuclear (karyorrhectic) debris and numerous small CD68(+) and CD123(+) monocytes. These aforementioned features have been described in cutaneous lesions of Kikuchi-Fujimoto disease, an entity whose clinicopathologic findings overlap with both infectious mononucleosis and lupus erythematosus. Serologic evidence of active and chronic active EBV infection was found in both patients, respectively. No evidence of EBV or HHV6 was found in the cutaneous lesions. Plasmacytoid monocytes (CD68(+)/CD123(+) cells), which produce type I interferon, are believed to play a role in viral immunity by protecting other cells from viral infections and promoting survival of antigen-activated T cells. Their presence in these two putative examples of viral-drug immune dysregulation could be a clue to pathogenesis and represent a common cellular component of some adverse cutaneous drug eruptions.

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“…Other cutaneous manifestations in association with EVB infection are papulous acrodermatitis in GianottiCrosti syndrome [14] and a granuloma-annulare-like eruption [15]. Recently, Fermand et al [16] demon strated a viral genome directly from the epidermis of skin lesions of a patient with chronic lymphocytic leukemia. These findings strongly suggest that the EBV played a role in the production of cutaneous pathologic changes.…”

Section: Discussionmentioning

confidence: 99%

“…There are several reports on cases with skin lesions associated with EBV infection [12][13][14][15][16]. In infectious mononucleosis, generalized macular erythema, urticaria or scarlatiniform eruptions were observed [12].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Mucocutaneous Lymphocytic Infiltration Possibly Associated with Epstein-Barr Virus Infection

Okada¹,

Tei²,

Yamamura³

et al. 1991

Dermatology

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A 32-year-old man had a history of recurrent but self-healing necrotizing nodules on the face and oral mucosa. Histologically the lesion was composed of necrotizing foci surrounded with dense CD8+ T lymphocytic infiltration in the dermis. Laboratory examination showed marked blood CD8+ T lymphocytosis with a reversed ratio of CD4+/CD8+ of 0.11. Except for a very high titer of antibodies against Epstein-Barr-virus-associated antigens, no signs of infection were observed.

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Detection of Epstein-Barr Virus in Epidermal Skin Lesions of an Immunocompromised Patient

Cited by 37 publications

References 23 publications

Treatment of B-lymphoproliferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients: a multicenter phase 1-2 clinical trial

Treatment of B-lymphoproliferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients: a multicenter phase 1-2 clinical trial

Adverse Antibiotic-Induced Eruptions Associated With Epstein Barr Virus Infection and Showing Kikuchi-Fujimoto Disease-Like Histology

Recurrent Mucocutaneous Lymphocytic Infiltration Possibly Associated with Epstein-Barr Virus Infection

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