Parvovirus B19: Un virus ADN asociado a múltiples manifestaciones cutáneas / Parvovirus B19: A DNA virus associated with multiple cutaneous manifestations

Resumen El parvovirus B19 es un virus ADN comunitario distribuido a nivel mundial con seroprevalencias que alcanzan hasta 85% en el adulto mayor. Existe un amplio espectro de manifestaciones clínicas en la infección por parvovirus B19 siendo las cutáneas las más frecuentes. Si bien, la mayoría de éstas son autolimitadas, existen numerosos síndromes y enfermedades autoinmunes en los cuales se postula al parvovirus B19 como factor gatillante, dada su capacidad de inducir la producción de numerosos autoanticuerpos y promover la presentación de autoantígenos a linfocitos T. En la presente revisión se describe el espectro de manifestaciones cutáneas de la infección por parvovirus B19 y la evidencia que apoya su asociación con cada una de ellas. Se propone una clasificación de las diferentes enfermedades con manifestaciones cutáneas vinculadas al parvovirus B19, basado en la cantidad y calidad de la evidencia disponible en la literatura científica.

Parvovirus B19 is a community DNA virus with worldwide distribution with up to 85% seroprevalence in the elderly. There is a wide spectrum of clinical manifestations in parvovirus B19 infection of which cutaneous involvement is the most frequent one. Although most of these are self-limiting conditions, there are numerous syndromes and autoimmune diseases in which parvovirus B19 is postulated as a triggering factor, given its ability to induce the production of various autoantibodies and promote the presentation of autoantigens to T cells. This review describes the spectrum of cutaneous manifestations of parvovirus B19 infection and the evidence supporting its association with each of them. We propose a new classification of different diseases with cutaneous manifestations linked to parvovirus B19, based on the amount and quality of available evidence in the literature.

Manifestaciones cutáneas en donantes de sangre portadores de HTLV-1 en comparación con donantes de sangre no portadores de HTLV-1 / Cutaneous manifestations detected in human T cell lymphotropic virus type 1 infected Chilean blood donors

Background: Most human T cell lymphotropic virus type 1 (HTLV-1) infected individuals are asymptomatic, but they commonly present cutaneous lesions that could be considered warning signs of the disease. Aim: To identify the main cutaneous manifestations present in HTLV-1 infected blood donors and compare them with healthy donors. Materials and Methods: Two blood donor groups from the blood bank of an emergency hospital were matched according to gender and age. One group was formed by HTLV-1 (+) (cases) and the other by HTLV-1 (-) donors (controls). A blind examiner to the serologic condition, evaluated their cutaneous manifestations. Results: Twenty five cases and 25 controls aged 18 to 60 years (24 females) were evaluated. One or more cutaneous manifestations were found in 24 (96%) cases and in 15 (60%) controls (p < 0.01). Inflammatory cutaneous diseases were found in 19 (76%) cases and in 9 (36%) controls (p < 0.01). Dermatophytosis was found in 18 (72%) cases and in 12 (48%) controls (NS). Conclusions: HTLV-1 infected Chilean subjects have a higher frequency of dermatoses than their healthy counterparts.

Chronic hepatitis ''C''; a dermatologic perspective

To find spectrum of various dermatological manifestations during hepatitis "C" virus infection in local population of hyderabad. This descriptive study was conducted in medicine department of Isra University Hospital Hyderabad from January 2011 to June 2012. A total of 325 anti-HCV positive patients were enrolled. All patients were subjected to detailed history, careful clinical examination of skin by a dermatologist to diagnose skin disease. All data was analyzed using statistical package SPSS 14.0. A total of 325 HCV positive patients [61% males and 39% females] were enrolled in this study. Mean age was 43 [SD+10 years], ranging from 15 to 78 years. About 41% had one or more dermatologic manifestations. Pruritis was the leading manifestation found in 11%, lichen planus [oral and cutaneous] was next to be found in 6.7% patients and hyperpigmentation in 5.2% patients. Urticaria [acute and chronic] was next counting in 5.23%. Jaundice, alopecia and vitiligo were seen in 4.9% each. Dry skin and interferon injection site erythema were observed in 4.6% patients each. Cutaneous vasculitis was noticed in 3.6% each, while photosensitivity, psoriasis and Raynaud's phenomenon were seen in 1.8%, 2.5%, 1.5% patients respectively. Dermatological manifestations are very common in patients with chronic HCV infection and when confronted with a suspected skin lesion, patient should be screened for it. Epidemiological studies are essential to determine the real prevalence of other dermatoses during course of HCV infection

The profile of the dermatoses in children with the HIV virus at the Fundação de Medicina Tropical do Amazonas / Perfil das dermatoses em crianças portadoras do vírus HIV na Fundação de Medicina Tropical do Amazonas

BACKGROUND: The Acquired Immunodeficiency Syndrome (AIDS) constitutes a sub-epidemic in Brazil. Due to the increasing number of women infected by the virus, the vertical transmission increased substantially, and due to the lack of adequate prophylactic treatment, many children are infected and show manifestations of the disease in early ages. Multiple systems are affected by the HIV virus, and the skin is often the first organ to be involved. OBJECTIVES: The objective of this study is to analyze the clinic, dermatological and epidemiological profiles of children carriers of the virus in the City of Manaus aiming at identifying the most frequent dermatoses that affect these children and try to relate these dermatoses to the immunologic deterioration. METHODS: A study was conducted where children carriers of the HIV virus from the Fundação Alfredo da Matta and Fundação de Medicina Tropical were studied from March 2007 to July 2008. These children were submitted to dermatological and laboratorial exams such as viral load dosage and CD4+ and CD8+ counts. RESULTS: During the study period, 70 HIV + children were examined; all of them had AIDS and had been contaminated by vertical transmission. The average number of dermatoses by children was 1.73, and 95.5% had at least one dermatosis during the study period. The most frequent manifestations were atopic dermatitis (22.9%), childhood prurigo (20%) and warts (18,6%). CONCLUSIONS: Children with HIV/AIDS have more skin disorders than children without HIV/AIDS. There was no statistical difference between the children in the group using ARVT and the group that wasn't using it.

FUNDAMENTOS: A Síndrome da Imunodeficiência Adquirida (AIDS) tem se configurado como uma sub-epidemia no Brasil, devido ao crescente número de mulheres infectadas pelo vírus, a transmissão vertical aumentou significativamente, e devido à falta de tratamento profilático adequado, muitas crianças são infectadas e convivem com as manifestações da doença precocemente. Múltiplos são os sistemas acometidos pelo vírus HIV, sendo a pele muitas vezes o primeiro órgão acometido. OBJETIVOS: O estudo teve por objetivo analisar o perfil clínico-dermatológico e imunológico das crianças portadoras do vírus HIV na cidade de Manaus com a finalidade de identificar as dermatoses mais freqüentes que as acometem e relacioná-las com a deterioração de seu sistema imunológico. MÉTODOS: Realizou-se um estudo onde foram acompanhadas entre março de 2007 a julho de 2008, crianças portadoras do vírus HIV atendidas na Fundação de Medicina Tropical do Amazonas. Estas foram submetidas a exame dermatológico e a exames laboratoriais como dosagem de carga viral, CD4+, CD8+. RESULTADOS: Durante o período estudado, foram atendidas 70 crianças HIV+, todas já apresentavam AIDS e tinham sido contaminadas por transmissão vertical. A média de dermatose por criança foi de 1,73 sendo que 95,5% apresentaram pelo menos uma dermatose. As manifestações mais freqüentes foram: dermatite atópica (22,9%), prurigo estrófulo (20%) e verruga (18,6%). CONCLUSÃO: As crianças com HIV/AIDS apresentaram mais dermatoses do que as crianças sem HIV/AIDS. Não houve diferença estatística em relação às dermatoses entre o grupo de crianças que estava em uso de Terapia antiretroviral (TARV) e o que não estava.

Frequency of mucocutaneous manifestations in HIV positive Pakistani patients

Mucocutaneous manifestations are commonly observed in HIV patients. These range from various opportunistic infections, inflammatory dermatoses to neoplasms and drug reactions. To observe the nature and frequency of mucocutaneous manifestations in patients of HIV, with or without antiretroviral therapy and their correlation with CD4 cell counts. The duration of study was one year, starting from July 2009 to July 2010. The patients were enrolled from the HIV clinic and inpatient departments of Jinnah Hospital Lahore. Patients meeting the inclusion and exclusion criteria were subjected to a detailed history and clinical examination. Investigations were carried out where required. Treatment profile was also noted. The data was recorded on a pro forma and was analyzed later. A total of sixty two patients were enrolled in the study. There were 49 [79%] males and 13 [21%] females. The age range was 4 to 58 years. Cutaneous manifestations were seen in 51 [82%] patients. The most common cutaneous findings were fungal infections seen in 33.87% patients, followed by viral infections [29.03%], xerosis [22.58%] and bacterial infections [12.9%]. Less common manifestations were photosensitivity, scabies and hyperpigmentation. CD4 cell count was found to be more than 455xl0[9]/ in 22 patients while it was less than 455xl0[9]/in 40 patients. Skin manifestations were found in 19 [86.36%] patients with a high count and in 33 [82.5%] patients with a low count. Cutaneous manifestations are commonly seen in patients of HIV infection

Virus Papiloma Humano (HPV): Parte II - Clínica y terapéutica / Human Papilloma Virus (HPV). Part II – Clinic and therapeutics

Los virus papiloma humano (HPV) pertenecen a la familia de los Papovaviridae y están ampliamente distribuidos en la naturaleza. Se han identificado más de 130 tipos. Pueden comprometer la piel y mucosas provocando lesiones benignas llamadas verrugas. Algunos tipos se asocian con el desarrollo de procesos malignos epiteliales. La respuesta inmune del huésped cumple un rol importante en el control de la infección. El diagnóstico es esencialmente clínico, pero a veces se recurre al estudio histopatológico de las lesiones o al empleo de técnicas de biología molecular. Existe una variedad de opciones terapéuticas, la mayoría destinada a destruir las lesiones. Últimamente se han desarrollado vacunas preventivas para algunos tipos de HPV y se encuentran en experimentación las vacunas terapéuticas.

The human papillomavirus belongs to the family of the Papillomaviridae. This virus is widely distributed in the nature. More than 130 types have been indentifi ed; they can compromise the skin and mucous membranes provoking benign injuries called warts. Some types of virus are said to be involved in the development of precancerous skin lesions. The host immune response has an important role on controlling the infection. The diagnosis is essentially clinic, nevertheless, sometimes histopathologic study of lesions or molecular biology techniques are needed in order to reach an accurate diagnosis. There is a great variety of treatment options; most of them aim to destroy the lesion. Lately some vaccines have been being developed; these are only for some types of HPV and are still under experimental designs (Dermatol Argent 2010;16(2):102-109).

prevalence of HCV antibodies in skin disease patients in Saudi Arabia

Hepatitis C virus [HCV] infection is a worldwide health issue with about 3% of the world's population having HCV. In Saudi Arabia, prevalence ranges from 1.0% to 5.87%. Cutaneous diseases can indicate the presence of HCV infection. The research project aims to identify prospectively the prevalence of HCV infection in 200 patients with various types of skin disorders and 50 healthy blood donors, and to quantify this association through clinical and laboratory investigations. Two hundred patients with cutaneous manifestations who presented at the Dermatology outpatient clinics of King Khalid University Hospital [KKUH] and King Abdulaziz University Hospital [KAUH], Riyadh, and 50 healthy blood donors were prospectively studied. Patients were examined by a team of dermatologists and clinical data were collected through a standard questionnaire. Ten milliliters of venous blood were collected from fully consented, 8-1 Oh fasting patients and serum was analyzed for AST, ALT, double infection with HBsAg, anti-HCV antibodies, and screened for HCV-RNA-PCR. Patients from the study [n = 200] consisted of 25 [12.5%] males and 175 [87.5%] females, with a mean age of 42.9 +/- 15.06 years. Clinical examinations revealed that [35%] had urticaria, followed by pruritus [28%], lichen planus [25.5%], prurigo [10%], and palpable purpura [1.5%]. The main serum levels of ALT and AST were within the normal reference ranges. Twenty-four patients [12%] tested positive for anti-HCV antibodies, with 15 [62.5%] being positive for the presence of HCV-RNA by PCR and 9 [37.5%] resulting negative for the viral RNA. Of the 24 anti-HCV positive patients, pruritus 12 [50%], urticaria 5 [20.8%], lichen planus 5[20.8%], and palpable purpura 2[8.3%]. Five [2.5%] patients were positive for HBsAg, with 3 [60%] having pruritus and 2 [40%] presenting with urticaria. Of the 50 healthy blood donors, only one [2%] tested positive for the presence of anti-HCV antibodies, and all the donors tested negative for HBsAg. Results clearly indicate the prevalence of anti-HCV antibodies in 24 out of 200 patients [12%] with skin manifestations seen at the dermatology outpatient clinics and documented with HCV-RNA-PCR positivity of 15/24 [62.5%]. A p-value of <0.05 was considered significant, therefore, it is suggested that patients presenting with urticaria, pruritus and LP be investigated to exclude the possibility of HCV infection

Eccema coxsackium / Eczema coxsackium

Presentamos un caso de erupción variceliforme de Kaposi en una niña con dermatitis atópica que previamente había tenido una erupción típica de enfermedad mano-pie-boca (eccema coxsackium). Las lesiones se desarrollaron en la zona del pañal, sobreimpuestas en una dermatitis preexistente que afectaba esa zona.

Psoriasis: Is it viral-induced?

The etiology of psoriasis as a disease is still not clear. In many other chronic diseases of previously unknown etiology a genetic and, or viral background has been proved or seems likely to be proved. It seems reasonable to consider psoriasis in the same way. This paper gives a review of articles that support a viral etiology of psoriasis based on genetic susceptibility

Electron microscopic studies of herpes zoster of the skin

Five patients with herpes zoster of the skin were subjected to electron microscopic studies. These studies revealed the presence of viral particles inside the nucleus, cytoplasm and in the intercellular spaces between adjacent keratinocytes. The virions were present also in the dermis inside the cytoplasm of the capillary endothelial cells and in its lumen. The virus particles also invaded the axons of unmyelinated nerve fibres and the fibroblasts. The virus particles are surrounded by a capsid that develops a membrane on the outer surface during multiplication. Some viruses show a central small electron dense core. However, the virions present in the extracellular space showed an empty core