High prevalence of specific KIR types in patients with HHV-8 positive cutaneous vascular lesions: a possible predisposing factor?

Human herpesvirus 8 (HHV8) has been hypothesized to be a potential cofactor for the development of diverse cutaneous vascular proliferative lesions, including eruptive cherry angiomas. Recent reports evidenced the influence of killer cell immunoglobulin-like receptor (KIR) gene diversity in defining the susceptibility to symptomatic herpesvirus infections. In this study, skin samples from vascular lesions and healthy controls were characterized simultaneously for the presence of HHV8 and for the KIR genotype, focusing upon the presence of the KIR2DL2/DS2 and KIR2DL3 genes, which have been associated to herpesvirus susceptibility. The results showed that about 64 % of the vascular lesions resulted positive for the presence of HHV8, whereas no control healthy skin samples harbored HHV8 DNA. HHV8-positive patients had a significantly increased frequency of KIR2DL2/DS2 homozigosity and a concomitant decrease of the homozygous KIR2DL3 genotype, compared to healthy controls or HHV8-negative patients. Notably, the simultaneous presence of KIR2DL2/DS2 homozygosity and HHV8 infection resulted in a significantly increased risk to develop cutaneous lesions (OR 5.7) compared to the individual factors alone, suggesting that specific KIR genotypes might predispose to HHV8 symptomatic infection, allowing the virus to exert its angioproliferative activity at skin level.

Human papillomavirus in rare unilateral benign intranasal tumours.

BACKGROUND: Inverted papilloma (IP), oncocytic papilloma (OP), respiratory epithelial adenomatoid hamartoma (REAH) and capillary hemangioma (CH) are benign and rare tumours. OP and IP are associated with squamous cell carcinoma (SCC). Human papillomavirus (HPV) may play a role in malignant transformation. AIM: We aimed to investigate the presence of HPV, inflammation, epithelial dysplasia, and prognostic markers including proliferative cell nuclear antigen (PCNA), epidermal growth fac- tor receptor (EGFR) and p53 in tissue specimens from rare unilateral intranasal benign tumours. METHODS: Presence of HPV DNA was detected by PCR. Proliferative cell nuclear antigen, EGFR, p53 expression and the presence of HPV type 16 in tissues were determined by immuno-histochemical analysis. RESULTS: We determined the presence of HPV DNA in 2 of 6 IP cases, in one CH patient and one OP patient, but the REAH patient was negative. Histologically, only one specimen with IP was positive for HPV type 16 being the high risk type. The remaining cases were considered as low risk type HPV. CONCLUSION: Although our patient numbers are limited, there is a significant association between IP and HPV. This is the first study showing the cooccurrence of CH and OP with HPV.

Human herpesvirus-8-positive microvenular hemangioma in POEMS syndrome.

We report a case of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome in a 55-year-old African American woman in which human herpesvirus-8 (HHV-8) was demonstrated within rare lymphocytes in a Castleman disease lymph node biopsy and numerous endothelial cells and lymphocytes in a microvenular hemangioma skin biopsy. Initial symptoms and findings of night sweats, weight loss, anorexia, generalized lymphadenopathy, and hemangiomas improved after chemotherapy with cyclophosphamide and prednisone. However, in the year following the initial diagnosis, the patient suffered from recurrent bouts of night sweats, gastroparesis, and lymphadenopathy, which required further treatment with plasmapheresis, cyclophosphamide, prednisone, and rituximab. One year later, the patient is asymptomatic but has persistent gammopathy. Although HHV-8 has previously been detected in POEMS-associated Castleman disease tissue, to our knowledge, this is the first case report in which HHV-8 has been directly demonstrated within the endothelial cells of a POEMS-associated hemangioma.