Vasculitis periflexual como manifestación de primoinfección por parvovirus B19: a propósito de un caso / Periplexual vasculitis as a manifestation of primary infection by parvovirus B19: about a case

La infección por parvovirus B19 es común, siendo más recurrente en la edad escolar, invierno y primavera, y su seroprevalencia alcanza hasta el 85% en adultos mayores. La presentación típica de la infección por este virus se conoce como eritema infeccioso (o "quinta enfermedad", destacando la afectación facial característica y la erupción reticulada), sin embargo, se han reportado múltiples manifestaciones dermatológicas de la infección por el virus. Paciente de 17 años, con antecedente de migraña, que desarrolló máculas y pápulas eritematoso-violáceas confluentes con petequias, predominando en pliegues antecubital, poplíteo e inguinal y cara lateral del tórax, con menor compromiso abdominal, espalda y muslos. La biopsia de la piel y los exámenes de laboratorio fueron compatibles con vasculitis leucocitoclástica secundaria a infección por parvovirus B19. Se han descrito diferentes patrones de la manifestación cutánea de la infección por parvovirus B19. La paciente del caso clínico expuesto desarrolló un rash cutáneo que constituyó una superposición entre el patrón vasculítico y el periflexural, presentación poco descrita en la literatura.

Parvovirus B19 infection is common, being more typical among school-age children, with seasonal changes. Infectious erythema (or 'fifth disease') is the classic manifestation of this viral infection; however, multiple dermatological manifestations of the virus infection have been reported. An otherwise healthy 17-year-old female patient, developed confluent erythematous-violaceous macules and papules with petechiae. They mainly involved the antecubital, popliteal and inguinal crease and lateral thorax. The lower abdomen, back and thighs were less involved. The skin biopsy and laboratory workup showed leukocytoclastic vasculitis and positive reaction for parvovirus B19, respectively. A variety of patterns have been described related to the cutaneous manifestation of parvovirus B19 infection. In the present case, the patient developed a cutaneous rash that constituted an overlap between the vasculitic and the periflexural patterns. This variant of parvovirus B19 infection has not been frequently described in literature.

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

Cytomegalovirus (CMV)-related cutaneous necrotizing vasculitis: case report and literature review

Cytomegalovirus (CMV) infection is usually asymptomatic in immunocompetent patients. A mononucleosis-like syndrome may develop in some patients. Various organ involvements (eg: encephalitis, meningitis, retinitis, myocarditis, pneumonia, hepatitis, enterocolitis, neuritis), which rarely occur in immunocompetent patients, have also been reported. Cutaneous necrotizing vasculitis caused by CMV infection has been reported very rarely in the literature. Here, a case with a very rare clinical form of CMV infection, presenting with persistent fever and livedo reticularis on the extremities and cutaneous necrotizing vasculitis of the toes, is described, and the relevant literature is reviewed. This case report aims to highlight the possibility of CMV infection to be a cause of cutaneous necrotizing vasculitis.

Vasculitis e infección viral / Vasculitis and viral infection

A 17 pacientes con diagnóstico de vasculitis primaria idiopática se les realizó valoración inmunitaria y de anticuerpos antivirales. Se comparó su biometría hemática y sus anticuerpos antivirales con 25 testigos sanos. Todos los pacientes y testigos HIV y HBV resultaron negativos. Se demostró actividad viral por IgM en ocho pacientes: cinco con púrpura vascular, una con enfermedad de Takayazu, una con poliarteritis nodosa y la otra con eritema nodoso. Ningún testigo tuvo IgM positiva. Se detectaron 14 anormalidades en la biometría hemática de los pacientes y en cuatro testigos. Los pacientes exhibieron respuestas de anticuerpos IgG menores que los testigos, alteraciones en subpoblaciones linfocitarias y complejos inmunitarios circulantes. El 47 por ciento de los pacientes tenía infección viral activa, pero la característica predominante fue una respuesta inmunitaria anormal en 82 por ciento