Human T‐lymphotropic Virus 1 (HTLV‐1) infection – dermatological implications

Abstract

Human T-lymphotropic virus type 1 (HTLV-1) is a type C retrovirus primarily endemic to Japan, Central and South America, the Middle East, regions of Africa, and the Caribbean. Currently, an estimated 10-20 million people worldwide are infected with this virus. Although the majority of infected individuals remain asymptomatic, HTLV-1 is the causative agent of a number of disorders, notably adult T-cell leukemia/lymphoma (ATLL) and a progressive demyelinating neurological disorder, HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In addition to ATLL and HAM/TSP, HTLV-1 has been associated with a spectrum of skin disorders, such as infective dermatitis associated with HTLV-1, crusted scabies, and leprosy. The understanding of the interaction between virus and host response has improved markedly, but there are still few treatment options.

Adult T-Cell Leukemia/Lymphoma

“…5 Because of nonspecific findings and a resemblance to other cutaneous T-cell lymphomas, the differential diagnosis can be challenging on histology and requires the use of HTLV-1 antibodies to HTLV-1 provirus DNA in tumor cells to label ATLL-associated skin lesions. 25 …”

“…Lymphoma cells expressing CCR4 are associated with skin involvement and bad prognosis. 25 Smoldering type associated with nodulotumoral-type skin lesions has a worse prognosis compared with smoldering type without skin lesions. 24 Additional poor prognostic indicators include age older than 40 years, advanced performance status (2 or more grade) with performance status (PS) based on the 5-grade scale of the World Health Organization, hypercalcemia, high blood lactate dehydrogenase level, b 2 -micro globulin, high serum CD25 levels, more than 3 extranodal lesions, liver and spleen enlargement, lymphadenopathy, and expression of drug-resistance protein and lung-resistance protein.…”

“…1 Adult T-cell leukemia/lymphoma with primary skin lesions without systemic involvement has better prognosis compared with cases with secondary skin involvement. 25 Erythrodermic-type cutaneous lesions have a shorter survival time, followed by the nodulotumoral and multipapular types. The patch and plaque types are linked to better outcomes.…”

Two Cases of Tuberculosis Manifesting as Cutaneous Solitary Mass in Patients with Adult T-Cell Leukemia/Lymphoma

“…ATL often manifests with non-specific skin lesions for some infections such as leprosy, scabies and superficial mycoses, in addition to the specific tumoral skin lesions [3]- [6].…”

“…Non-specific skin manifestations have been investigated for infections such as leprosy, scabies and superficial mycoses, which can frequently be complicated with ATL, resulting from immunosuppression caused by tumor progression [3]- [6]. With regard to tuberculosis (TB), one review suggests that patients with ATL have an increased risk of TB compared with the general population without ATL [7].…”