Unusual varicella zoster virus infection in patients with the acquired immunodeficiency syndrome

Alessi, E.

doi:10.1001/archderm.124.7.1011

Cited by 15 publications

(6 citation statements)

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“…Individuals aged 4-48 years can be affected. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][37][38][39][40][41] Although there is a significant clinical polymorphism of chronic verrucous VZV lesions, the typical presentation consists of single or multiple pox-like or wart-like hyperkeratotic and well demarcated lesions which vary from 4 mm to 10 cm in diameter ( Fig. 1).…”

Section: Clinical Aspectsmentioning

confidence: 99%

Chronic verrucous varicella zoster virus skin lesions: clinical, histological, molecular and therapeutic aspects

Nikkels

Snoeck

Rentier

et al. 1999

Clinical and Experimental Dermatology

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SummaryThe outbreak of HIV infection introduced a new phenomenon in varicella zoster virus (VZV) pathology, namely the long-standing wart-like skin lesions that are frequently associated with resistance to thymidine kinase (TK)-dependent antiviral agents. This paper reviews the clinical, histological, and molecular aspects and the therapeutic management of these verrucous lesions. The majority of lesions are characterized by chronically evolving, unique or multiple wart-like cutaneous lesions. The main histo-pathological features include hyperkeratosis, verruciform acanthosis and VZVinduced cytopathic changes with scant or absent cytolysis of infected keratinocytes. The mechanism that establishes the chronic nature of the lesions appears to be associated with a particular pattern of VZV gene expression exhibiting reduced or nondetectable gE and gB synthesis. Drug resistance to TKdependent antiviral agents is a result of nonfunctional or deficient viral TK. This necessitates alternative therapeutic management using antiviral agents that target the viral DNA polymerase.

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Section: Clinical Aspectsmentioning

confidence: 99%

Chronic verrucous varicella zoster virus skin lesions: clinical, histological, molecular and therapeutic aspects

Nikkels

Snoeck

Rentier

et al. 1999

Clinical and Experimental Dermatology

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“…The histologieal features of herpetic infecdon in HIV-positive patients may be atypical and may lack the typical epidermal alterations, observing only an extensive epidermal necrosis (20,21). In those cases, the alterations of the eccrine ducts may be a diagnostic clue in the diagnosis of herpedc infecdon.…”

Section: Discussionmentioning

confidence: 99%

Herpetic syringitis associated with eccrine squamous syringometaplasia in HIV‐positive patients

et al. 1997

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Herpetic syringitis has been described as a rare manifestation of herpes virus infection in patients with an immunodeficiency, usually secondary to human immunodeficiency virus (HIV) infection. Eccrine squamous syringometaplasia (ESS) is an infrequent alteration of the eccrine duct epithelium reported in association with several conditions, including chronic ulcers, inflammatory processes, and patients receiving chemotherapy. The association of herpetic syringitis with ESS has not been reported before. We identified 3 cases of herpetic syringitis associated with ESS in patients with the acquired immunodeficiency syndrome. In 2 of 3 cases the signs of herpetic syringitis were limited to the metaplastic duct epithelium, but in 1 case there were also herpetic alterations without ESS. The histological features of herpetic infection in HIV-positive patients may be atypical and lack the typical epidermal alterations, observing only an extensive epidermal necrosis. In those cases, the alterations of the eccrine ducts may be a diagnostic clue in the diagnosis of herpetic infection. ESS of the ductal epithelium is probably secondary to the herpetic infection, although it might also stimulate the extension of the herpetic infection. Further studies are needed to elucidate the association of ESS and herpes virus infection.

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“…Besides widespread distribution (multisegmental or generalized), poxlike ulcerations and ecthymatous persistent and hyperkeratotic/verrucous lesions have been described. [1][2][3][4][5][6] Because immunodeficiency requires prolonged high-dose and sometimes recurrent antiviral therapy, thymidine kinase-free wild-type VZV strains, which are unable to phosphorylate aciclovir to its active form, are promoted. 3,6 Consequently, aciclovir resistance is more likely in these patients.…”

Section: Hyperkeratotic Varicella Zoster Virus Infection In An Hiv-inmentioning

confidence: 99%

“…SIR, Molluscum contagiosum is a common skin infection in advanced HIV disease, when it may be extensive and refractory to standard topical therapies. [1][2][3][4][5]…”

Section: Resolution Of Severe Molluscum Contagiosum On Effective Antimentioning

confidence: 99%

Hyperkeratotic varicella zoster virus infection in an HIV-infected patient. Successful treatment of persistent lesions with cryosurgery

Schöfer

Baur

Gregel

et al. 1998

British Journal of Dermatology

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Unusual varicella zoster virus infection in patients with the acquired immunodeficiency syndrome

Cited by 15 publications

References 0 publications

Chronic verrucous varicella zoster virus skin lesions: clinical, histological, molecular and therapeutic aspects

Chronic verrucous varicella zoster virus skin lesions: clinical, histological, molecular and therapeutic aspects

Herpetic syringitis associated with eccrine squamous syringometaplasia in HIV‐positive patients

Hyperkeratotic varicella zoster virus infection in an HIV-infected patient. Successful treatment of persistent lesions with cryosurgery

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