Human papilloma virus infection in the oral cavity‐a source of infection

Abstract

tion at that site [1,2]. Beard and colleagues, stressing the clinical and histological similarities between CIAE and graft-versus-host disease (GVHD), suggested that chemotherapeutic drugs, by changing cell surface receptors, are able to induce hostversus-altered host changes [6]. Nielsen described a palmar-plantar erythema in a patient with a myeloproliferative disease who had received neither antineoplastic drugs nor a blood transfusion, but only ampicillin and gentamicin, underlining the fact that myelodisplastic disease may itself have a role in the pathogenesis of CIAE [7]. Troussard and colleagues described three patients who underwent allogenic bone marrow transplantation, after a conditioning regimen including AraC or etoposide, that developed CIAE followed by acute GVHD [8]. The histopathologic pictures of CIAE are characterized by mild basal vacuolization, isolated dyskeratotic cells and a mild superficial mononuclear infiltrate similar to those seen in erythema multiforme and acute GVHD [ 1,6]. Our case is of interest because the complete necrolysis of the epidermis with no signs of dermal vasculitis, similar to those seen in toxic epidermal necrolysis, has never before been histologically documented. These findings indicate that CIAE may be considered as being part of the interface dermatitis group, in which the cytotoxic effects are prevalent over the immunologic ones. [l] B a c k BR, Burgdod WHC. Chemotherapy-induced acral erythema. J Am Acad Dermatol 1991;24:457-461. Herzig GP. High-dose cytosine arabinoside therapy for refractory leukemia. Blood 1983;62:361-369. [3] Lokich JJ, Moore C. Chemotherapy-associated palmar-plantar erythodysestesia syndrome. Ann Inter Med 1984; [4] De Argila D, Dominguez JD, Iglesias L. Taxol-induced acral erythema.