Herpes zoster-varicella in cutaneous T-cell lymphomas

Abstract

The overall frequency of herpes zoster-varicella (HZV) infection in 221 patients with histologically confirmed cutaneous T-cell lymphoma was 10% (22 patients). The frequency of HZV infection and serious complications (viral dissemination, bacteremia) was relatively high in patients with evidence of extracutaneous involvement, especially in patients with Sézary syndrome. The major factors identified to account for this predisposition to HZV infection include intensive treatment with radiation therapy or drugs given for systemic effect and/or immunologic deficiency consequent to advanced disease. These observations are quite similar to those made in patients with Hodgkin's disease.

Single-Cell Mass Cytometry Analysis of Human Tonsil T Cell Remodeling by Varicella Zoster Virus

“…These observations suggest that this constellation of T cell surface characteristics is especially effective in facilitating T cell trafficking to skin. That these changes enhance VZV transport to skin is reinforced by the very extensive cutaneous VZV lesions observed in CTCL patients when they develop infection (Vonderheid and van Voorst Vader, 1980). However, VZV does not cause malignant transformation of T cells even though infection activates T cell signaling pathways associated with oncogenesis, including STAT3/survivin (Sen et al, 2012) and PI3K/Akt, as shown here.…”

Pulmonary mycobacteriosis in a patient affected by mycosis fungoides: A diagnostic and therapeutic challenge

“…17 A study demonstrated that 63% of HIV-seronegative cancer patients with active tuberculosis in a cancer center had hematological malignancy. 21 After a thorough review of literature, we found two articles regarding varicella-zoster infection complicating CTCL 8,9 ; however, we could not find specific reports on pulmonary mycobacteriosis in these patients. To our knowledge, the coexistence of CTCL with pulmonary mycobacteriosis, i.e.…”

“…14 Compared with the general population, patients with adaptive cellular immune dysfunction are at increased risk of active tuberculosis 15,16 and varicella-zoster virus infection. 1,8 Among oncologic patients, those with Hodgkin's disease and head and neck cancer have been considered to be at high risk of tuberculosis. 17 A study demonstrated that 63% of HIV-seronegative cancer patients with active tuberculosis in a cancer center had hematological malignancy.…”

“…19,20 In our patient both the lymphoma and its treatment contributed to immunosuppression and may have predisposed to the development of pulmonary mycobacteriosis. 8,18,22 With regard to the diagnosis of lung infection, the first diagnosis proposed by radiologists was a post-radiotherapy process. The differential diagnosis was infiltration of the lung by lymphoma, as occurs in some cases.…”