RESUMEN
BACKGROUND: Infective dermatitis associated with human T-cell lymphotropic virus type 1 (HTLV-1; IDH) is a chronic recurrent eczema affecting HTLV-1-infected children. The epidemiological and dermatological characteristics of IDH are described, and their principal diagnostic criteria are reevaluated. METHODS: Forty-two patients were included: 40 patients serologically positive for HTLV-1 and 2 seronegative patients who tested positive in polymerase chain reaction (PCR) assays. RESULTS: The mean age at onset of the disease was 2.6 ± 2.4 years (range, 2 months-11 years). The mean duration of breast-feeding was 24.2 months. The lesions were erythematous, scaly, and crusted, always affecting the scalp and retroauricular regions. Crusting of the nostrils was observed in 64.3% of the patients. Of the 36 patients followed up, 23 had the active disease. The age at which IDH disappeared in the others was 10-20 years. CONCLUSIONS: The onset of IDH may occur earlier than reported in the literature. The scalp and retroauricular regions are always affected, and lesions are invariably present in ≥3 areas. Crusting of the nostrils cannot be considered an obligatory factor for the diagnosis of IDH. The recurring nature of IDH was a characteristic found in all cases. Patients with classic IDH lesions who are serologically negative should be investigated by PCR. Therefore, the indispensable criteria for diagnosis are (1) presence of erythematous-scaly, exudative, and crusted lesions involving ≥3 areas, including the scalp and retroauricular regions; (2) recurring nature of the lesions; and (3) a finding of HTLV-1 infection by serology or molecular biology.
Asunto(s)
Eccema/epidemiología , Infecciones por HTLV-I/complicaciones , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Enfermedades Cutáneas Infecciosas/epidemiología , Adolescente , Brasil/epidemiología , Niño , Preescolar , Técnicas de Laboratorio Clínico/métodos , Eccema/diagnóstico , Eccema/patología , Eccema/virología , Femenino , Infecciones por HTLV-I/virología , Humanos , Lactante , Masculino , Cuello/patología , Nariz/patología , Reacción en Cadena de la Polimerasa/métodos , Recurrencia , Cuero Cabelludo/patología , Enfermedades Cutáneas Infecciosas/diagnóstico , Enfermedades Cutáneas Infecciosas/patología , Enfermedades Cutáneas Infecciosas/virología , Virología/métodosRESUMEN
INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1) is sexually transmitted and causes persistent infection. This virus induces activation of the immune system and production of inflammatory cytokines. This study aimed to assess the cytokine profile and cytopathological findings in the cervicovaginal fluid of asymptomatic HTLV-1-infected women. METHODS: HTLV-1-infected and uninfected women were selected at the Centro de Atendimento ao Portador de HTLV in Salvador-Brazil. None of the included HTLV-1-infected women reported any HTLV-1-associated diseases. All volunteers underwent gynecological examination to collect cervicovaginal fluid. Cytokine quantification was performed using the Cytometric Bead Array (CBA) Human Th1/Th2/Th17 kit. Light microscopy was used to evaluate cervicovaginal cytopathology. In addition, proviral load in cervicovaginal fluid and peripheral blood was measured by real-time quantitative polymerase chain reaction. RESULTS: 112 women (63 HTLV-1-infected and 49 uninfected) were evaluated. No differences were found with respect to cytopathological cervicovaginal findings between the groups. IL-2, TNF, IL-4, IL-10, and IL-17 levels were significantly higher in cervicovaginal fluid of the HTLV-1-infected women than in uninfected women (p<0.05). Conversely, IFN-γ was found to be lower in the HTLV-1-infected women (p<0.001) compared to uninfected individuals. Cervicovaginal proviral load was detectable in 53% of the HTLV-1-infected women and was found to be consistently lower than the proviral load in peripheral blood. CONCLUSIONS: HTLV-1 infection induces immune activation in cervicovaginal environment, characterized by elevated concentrations of Th1, Th2, and IL17 in the cervicovaginal fluid.
Asunto(s)
Líquidos Corporales/química , Cuello del Útero/patología , Citocinas/análisis , Infecciones por HTLV-I/patología , Vagina/patología , Adulto , Líquidos Corporales/inmunología , Cuello del Útero/inmunología , Cuello del Útero/virología , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por HTLV-I/inmunología , Infecciones por HTLV-I/virología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Interleucina-17/inmunología , Leucocitos Mononucleares/virología , Clase Social , Estadísticas no Paramétricas , Células TH1/inmunología , Células Th2/inmunología , Vagina/inmunología , Vagina/virología , Carga ViralAsunto(s)
Leucemia-Linfoma de Células T del Adulto/patología , Neoplasias Cutáneas/patología , Adulto , Antígenos CD , Separación Celular , Diagnóstico Precoz , Citometría de Flujo , Humanos , Leucemia-Linfoma de Células T del Adulto/fisiopatología , Linfocitos/patología , Masculino , Fenotipo , Neoplasias Cutáneas/fisiopatologíaRESUMEN
Cutaneous lymphoid hyperplasia (CLH) can be idiopathic or secondary to external stimuli, and is considered rare in tattoos. The infiltrate can be predominantly of B or T-cells, the latter being seldom reported in tattoos. We present a case of a predominantly T CLH, secondary to the black pigment of tattooing in a 35-year-old patient, with a dense infiltrate of small, medium and scarce large T-cells. Analysis of the rearrangement of T-cells receptor revealed a polyclonal proliferation. Since the infiltrate of CLH can simulate a T lymphoma, it is important to show that lesions from tattoos can have a predominance of T-cells.
Asunto(s)
Eritema/etiología , Seudolinfoma/etiología , Linfocitos T , Tatuaje/efectos adversos , Adulto , Eritema/patología , Femenino , Humanos , Seudolinfoma/patología , Piel/patología , Linfocitos T/patologíaRESUMEN
ABSTRACT Introduction: Human T-cell lymphotropic virus type 1 (HTLV-1) is sexually transmitted and causes persistent infection. This virus induces activation of the immune system and production of inflammatory cytokines. This study aimed to assess the cytokine profile and cytopathological findings in the cervicovaginal fluid of asymptomatic HTLV-1-infected women. Methods: HTLV-1-infected and uninfected women were selected at the Centro de Atendimento ao Portador de HTLV in Salvador-Brazil. None of the included HTLV-1-infected women reported any HTLV-1-associated diseases. All volunteers underwent gynecological examination to collect cervicovaginal fluid. Cytokine quantification was performed using the Cytometric Bead Array (CBA) Human Th1/Th2/Th17 kit. Light microscopy was used to evaluate cervicovaginal cytopathology. In addition, proviral load in cervicovaginal fluid and peripheral blood was measured by real-time quantitative polymerase chain reaction. Results: 112 women (63 HTLV-1-infected and 49 uninfected) were evaluated. No differences were found with respect to cytopathological cervicovaginal findings between the groups. IL-2, TNF, IL-4, IL-10, and IL-17 levels were significantly higher in cervicovaginal fluid of the HTLV-1-infected women than in uninfected women (p < 0.05). Conversely, IFN-γ was found to be lower in the HTLV-1-infected women (p < 0.001) compared to uninfected individuals. Cervicovaginal proviral load was detectable in 53% of the HTLV-1-infected women and was found to be consistently lower than the proviral load in peripheral blood. Conclusions: HTLV-1 infection induces immune activation in cervicovaginal environment, characterized by elevated concentrations of Th1, Th2, and IL17 in the cervicovaginal fluid.
Asunto(s)
Humanos , Femenino , Adulto , Vagina/patología , Líquidos Corporales/química , Infecciones por HTLV-I/patología , Cuello del Útero/patología , Citocinas/análisis , Clase Social , Vagina/inmunología , Vagina/virología , Líquidos Corporales/inmunología , Ensayo de Inmunoadsorción Enzimática , Leucocitos Mononucleares/virología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Infecciones por HTLV-I/inmunología , Infecciones por HTLV-I/virología , Cuello del Útero/inmunología , Cuello del Útero/virología , Estudios Transversales , Células Th2/inmunología , Células TH1/inmunología , Estadísticas no Paramétricas , Carga Viral , Interleucina-17/inmunologíaRESUMEN
Fifteen families with clustering of infective dermatitis associated with HTLV-1 (IDH) and/or HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) were observed among 28 families of IDH index cases, 93% of them occurring in two generations. With the exception of two mothers of children with IDH, all the mothers with HAM/TSP had at least one child with HAM/TSP. This is the first report of such clustering involving many families.
Asunto(s)
Dermatitis/epidemiología , Dermatitis/virología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Paraparesia Espástica Tropical/epidemiología , Paraparesia Espástica Tropical/virología , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Análisis por Conglomerados , Femenino , Humanos , Lactante , Masculino , Persona de Mediana EdadRESUMEN
Cutaneous lymphoid hyperplasia (CLH) can be idiopathic or secondary to external stimuli, and is considered rare in tattoos. The infiltrate can be predominantly of B or T-cells, the latter being seldom reported in tattoos. We present a case of a predominantly T CLH, secondary to the black pigment of tattooing in a 35-year-old patient, with a dense infiltrate of small, medium and scarce large T-cells. Analysis of the rearrangement of T-cells receptor revealed a polyclonal proliferation. Since the infiltrate of CLH can simulate a T lymphoma, it is important to show that lesions from tattoos can have a predominance of T-cells.