11/82. Papular-purpuric gloves and socks syndrome in HIV-positive patients. Three HIV-positive women showed clinical signs of papular-purpuric gloves and socks syndrome and serologic evidence of acute parvovirus B19 infection. The course of the disease was complicated by anemia and persistent skin lesions, probably related to inadequate immune response. Because anemia in AIDS patients may be due to many causes, the history of recent parvovirus B19 infection is helpful in suggesting the etiologic diagnosis. ( info) |
| When cytomegalovirus (CMV) involves the skin, viral inclusions are typically present within mesenchymal cells, e.g., endothelial cells, fibrocytes, and sometimes within inflammatory cells, e.g., macrophages, in contrast to infection in other organs in which inclusions are usually present within ductal epithelial cells. Two cases of cutaneous CMV are presented, one showing prominent findings within eccrine ductal epithelium and the other revealing mostly endothelial cells affected by CMV. Due to the range of cytologic changes induced by CMV observed in these cases, there seem to be early, fully developed, and late cellular changes brought about by CMV analogous to how herpesvirus (varicella, zoster, simplex) induces different changes depending on its stage of infection. ( info) |
13/82. Epstein-Barr virus-associated peripheral T-cell lymphoma in adults with hydroa vacciniforme-like lesions. We describe two Korean adult patients who had necrotizing papulovesicles mainly on their faces. skin biopsy specimens showed perivascular and periadnexal infiltrate of atypical lymphoid cells with vasculitis in the dermis and subcutaneous tissue. in situ hybridization demonstrated a latent infection of Epstein-Barr virus in the majority of lymphoid cells in the dermis. These patients were diagnosed as having T-cell lymphoma. Interestingly, large granular lymphocytosis was found in the peripheral blood of Case 2. ( info) |
14/82. cytomegalovirus maculopapular eruption in a kidney transplant patient. cytomegalovirus (CMV) is the most important viral agent in kidney transplantation. Clinical manifestations of CMV disease in transplantation include hepatitis, pneumonitis, pancreatitis, kidney allograft dysfunction, colitis, and meningoencephalitis. However, skin involvement is rare. We describe a severely compromised cadaveric-kidney transplant recipient who developed renal failure, colonic ulcers, and a maculopapular rash accompanied by fever and malaise 4 months after transplantation. Only the skin biopsy was diagnostic and consistent with CMV disease. Intravenous ganciclovir administration resulted in clinical improvement of CMV-induced skin lesions; kidney function normalized and the patient became asymptomatic after 14 days of ganciclovir therapy. Nephrologists should consider the diagnosis of CMV disease in the febrile immunosuppressed patient with skin involvement. skin biopsy must be considered as a useful and safe procedure in patients with a rash to obtain a prompt diagnosis and efficiently treat this immunocompromised population. ( info) |
15/82. Prolonged herpes zoster in a patient infected with the human immunodeficiency virus. In 1983, varicella zoster virus (VZV) disease was first recognized in the context of infection with the human immunodeficiency virus (HIV). Since that time, there have been many reports discussing the occurrence and clinical manifestations of hepes zoster in HIV-infected patients. We describe the development of prolonged herpes zoster in a patient with acquired immunodeficiency syndrome (AIDS) over the course of 104 days. Viral isolates at the three different clinical stages of the skin lesions were sensitive in vitro to acyclovir, and supposed to be a same strain by polymerase chain reaction (PCR) analysis. We also discuss an effective treatment for prolonged cases of zoster. ( info) |
| Anogenital condylomata acuminata are the most frequent clinical manifestation of genital human papillomavirus (HPV) infection. association between human immunodeficiency virus (HIV) and HPV infections is frequent (range: 26-60% in males). Topical cidofovir (a nucleotide analogue antiviral drug active against a broad range of dna viruses) is a potential treatment for anogenital warts in immunocompromised patients. We treated three HIV-infected patients with HPV perianal condylomas with topical 1% cidofovir in flexible collodion once a day for 2 weeks. The treatment resulted in complete clearance of the HPV lesions. The patients experienced mild transient erythema without any other side-effects. None of the patients relapsed during the 10-14-month follow-up period. ( info) |
17/82. Eruptive pseudoangiomatosis. We describe two children with acute onset and spontaneous resolution of angioma-like papules during a viral illness. The biopsy specimens from both patients showed a unique histologic appearance consisting of dilated dermal blood vessels with plump, hobnail-shaped endothelial cells. On the basis of the natural history and the histopathologic features we suggest the diagnosis of eruptive pseudoangiomatosis. ( info) |
18/82. Tanapox: first report in a European traveller and identification by PCR. Tanapox is a rare pox disease endemic in East africa. We report the first case of tanapox in a European traveller who contracted the disease in 1999 during a short visit to tanzania. The diagnosis was made on clinical grounds and confirmed by electron microscopy and a tanapox virus-specific PCR assay. ( info) |
19/82. herpes simplex virus infection in a hyper-IgE patient: appearance of unusual mass lesions. A 7-year-old girl presented with large soft masses rising from the nostril and from behind the ear. She had previously been diagnosed as suffering from hyper-IgE syndrome. The presence of herpes simplex virus infection within these lesions was confirmed by biopsy and immunohistochemical studies. The mass lesions did not respond to antibacterial therapy with cefazolin, but improved promptly under antiviral therapy with acyclovir. Immunological studies revealed a mild decrease in the CD4 cell population. Based on our results and on the relevant literature we propose an immunological mechanism for this unique manifestation of herpes simplex virus infection in hyper-IgE syndrome. ( info) |
20/82. Case report. Severe cutaneous ulceration secondary to cytomegalovirus inclusion disease during successful immune reconstitution with HAART. Restoration of the immune system following HAART is not without its adverse effects. We describe a case of severe cutaneous ulceration secondary to cytomegalovirus (CMV) infection in an hiv-1-seropositive man following the initiation of HAART in the absence of active CMV retinitis and discuss the likely mechanisms associated with its development. ( info) |