The evolving natural history of infective dermatitis in Jamaica - abstract

ABSTRACT

Infective dermatitis (ID) of Jamaican children, described in 1966, has recently been shown to be associated with human T-lymphotropic virus type 1 (HTLV-1) infection. This retrospective study of patients with infective dermatitis attending the dermatology clinic since 1970 was undertaken to determine trends in the natural history of the disorder and to define any link with other established HTLV-I associated disorders such as adult T-cell leukaemia/lymphoma (ATL) and tropical spastic paraparesis (TSP). Eighty-one patients have been followed. The results indicate that scabies was the commonest associated disorder seen in 15 patients (18 percent), with crusted scabies in 2 of these patients. Corneal opacities were seen in 8 patients (10 percent). Tropical spastic paraparesis was seen in 3 patients;lymphocytic interstitial pneumonitis was seen in 2 patients both of whom were persistently negative for human immunodeficiency virus (HIV) antibodies. Chronic glomerulonephritis was seen in 2 patients which led to chronic renal failure and death in one of these. Three patients with infective dermaitis died, one of definite ATL and two of ATL-like syndromes. These results indicate that at least a proportion of patients with infective dermatitis are at risk of developing other HTLV-I associated disorders, as well as other disorders of the immune system. These patients therefore require careful long-term follow-up (AU)