Dermatological manifestations of individuals infected with human T cell lymphotropic virus type I (HTLV-I).

BACKGROUND: Human T cell lymphotropic virus type I (HTLV-I) is associated with specific manifestations such as adult T cell lymphoma/leukemia (ATLL), HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), HTLV-I-associated uveitis, and infective dermatitis associated with HTLV-I (IDH). Although ATLL and IDH are considered specific manifestations of HTLV-I infection, several dermatological manifestations have been described in HTLV-I seropositive patients. OBJECTIVES: This study was conducted to determine the prevalences of skin lesions in patients infected with HTLV-I in an area of Brazil endemic for HTLV-I infection and to compare these prevalences with those in seronegative individuals in the same region. METHODS: A prevalence study was conducted between 2008 and 2010 with two groups of individuals comprising, respectively, 179 HTLV-I seropositive (positive enzyme-linked immunosorbent assay [ELISA] and positive Western blot analysis) and 193 HTLV-I seronegative individuals (ELISA-negative). The subjects were selected on a random basis and evaluated using a questionnaire to obtain epidemiological and clinical data. A physical examination was performed to verify the presence of skin lesions. RESULTS: Superficial mycoses were found in 54 (30.2%) seropositive subjects and in 26 (13.5%) of the seronegative group (P < 0.001). Xerosis was found in 39.1% of HTLV-I infected subjects and in 9.3% of seronegative controls (P < 0.001). Ichthyosis was diagnosed in nine (5.0%) HTLV-I seropositive subjects but in none of the control group (P = 0.001). A diagnosis of seborrheic dermatitis was made in 43 (24.0%) HTLV-I infected subjects and in 24 (12.4%) seronegative controls (P = 0.004). Furthermore, dermatological manifestations were more intense in the HTLV-I seropositive group. CONCLUSIONS: Several dermatological manifestations are more common and more severe in HTLV-I seropositive subjects. The presence of these manifestations in an area endemic for HTLV-I infection may provide some clues in the investigation of this infection.

Genotyping by RAPD-PCR analyses of Malassezia furfur strains from pityriasis versicolor and seborrhoeic dermatitis patients.

Malassezia furfur is lypophilic yeast commonly associate with dermatological disorders. In the present work, we described the isolation of 47 M. furfur strains from three groups of patients: pityriasis versicolor (21 isolates), seborrhoeic dermatitis (15 isolates) and seborrhoeic dermatitis of the HIV positive patients (11 isolates). To investigate the identity of the strains at molecular level, DNA genomic of M. furfur strains were prepared and used to RAPD-PCR analyses. RAPD assay were carried out using two decamer primers and bands pattern generated were analyzed by an Unweighted Pair-Group Method (UPGMA). Dendrogram established a distinct differentiation between M. furfur isolates from pityriasis versicolor and seborrhoeic dermatitis patients with or without AIDS. We concluded that RAPD typing presented a high discriminatory power between strains studied in this work and can be applied in epidemiological investigation of skin disease causing by M. furfur.

Dermatologic lesions in asymptomatic blood donors seropositive for human T cell lymphotropic virus type-1.

Dermatologic manifestations are quite common in patients with adult T cell leukemia/lymphoma and myelopathy/tropical spastic paraparesis associated with infection with human T cell lymphotropic virus type-1 (HTLV-1). In this study, we evaluated the dermatologic lesions of eligible blood donors in the state of Minas Gerais in Brazil who were seropositive but asymptomatic for infection with HTLV-1. The study population was composed of 128 HTLV-1-seropositive individuals and 108 seronegative controls. All individuals underwent a dermatologic evaluation. Biopsy specimens were obtained from abnormal and normal skin samples of seropositive individuals in an attempt to detect HTLV-1 in tissue samples by a polymerase chain reaction. Dermatologic alterations were observed more frequently in the seropositive group (adjusted odds ratio [OR] = 8.77, 95% confidence interval [CI] = 4.11-18.71). The most common skin diseases were dermatophytoses (adjusted OR = 3.32, 95% CI = 1.50-7.35), seborrheic dermatitis (OR = 3.53, 95% CI = 0.67-24.66), and acquired ichthyosis (P = 0.001). Virus was detected more frequently in abnormal skin samples. Dermatologic lesions probably related to HTLV-1 infection were diagnosed in eligible blood donors who were infected with this virus, who were previously considered to be asymptomatic carriers of HTLV-1.