Low-Productive Alpha-Herpesviridae Infection in Chronic Lichenoid Dermatoses

Abstract

Background: Herpes simplex virus (HSV) and Varicella-zoster virus (VZV) are responsible for various atypical mucocutaneous manifestations in the immunosuppressed population. One of the causative pathomechanisms suggests an altered virus-host cell relationship. Objective/Methods: This report investigates by histology, immunohistochemistry and in situ hybridization the histological and virological features of 6 protracted, indolent HSV infections and 2 prolonged zoster infections. Results: Histopathology revealed a lichenoid dermatitis in all patients. Specific HSV-1, HSV-2 and VZV in situ hybridization proved the viral origin of the cutaneous lesions. Immunohistochemical assessment demonstrated the intracellular presence of the HSV glycoproteins gB, gC and gD in epidermal keratinocytes which did not exhibit cytolysis. Similar findings were obtained for the VZV gE and gB. Conclusion: These results suggest that in some instances HSV and VZV infections may present a protracted disease course associated with a lichenoid inflammatory pattern and a non-cytolytic virus-host cell relationship.

Herpes Simplex Virus Type-I and Pyogenic Granuloma: A Vascular Endothelial Growth Factor-Mediated Association

“…The nuclear and cytoplasmic HSV-I staining patterns in non-CPE-presenting epithelial cells are in line with a chronic, low-productive type of HSV infection, as observed in other chronic HSV infections [10]. The strong expressions of EGFR and Ki67 in the epithelial cells suggest that these cells are still replicating.…”

Chronic mucocutaneous herpes simplex virus and varicella zoster virus infections

“…10,11,[14][15][16][17][18][19] Chronic HSV skin infections (CHSV) 1,5,6,14,17,18, and chronic VZV skin infections (CVZV) 1,3,7,8,17,36, are among the most common atypical manifestations; these are defined as wart-like and/or ulcerative HSV or VZV mucocutaneous infections lasting for at least 1 month and must be distinguished from longstanding lichenoid, granulomatous and pseudolymphomatous HSV and VZV reactions. 16,89,90 Misdiagnosis is common and can delay appropriate treatment. 62 The subject of this review is the epidemiology, risk factors, clinical manifestations, localization, pathogenic mechanisms, diagnostic procedures, differential diagnosis and therapeutic management of CHSV and CVZV infections (Table I).…”

An Unusual Presentationof Herpes Simplex Virus Type 1Infection in a Child

“…These viruses account for a significant proportion of human cutaneous diseases and they cause similar histological and clinical findings [1]. Although herpes labialis, herpes vulvovaginitis, herpetic whitlow and herpes gladiatorum are the most well-known clinical features of the HSV-1 and HSV-2 infections, there are various descriptions of herpesvirus involvement in erythema multiforme, atopic dermatitis, lichenoid dermatitis and seborrheic keratosis [2, 3, 4, 5, 6]. Lichen simplex chronicus (LSC) and acute bilateral carpal tunnel syndrome (CTS) are unusual complications of herpesviruses, and apparently a few cases of adult patients have been reported previously [7, 8, 9].…”