ABSTRACT
Hydroa vacciniforme is a rare, usually quite severe, photo-dermatosis. Association with Epstein-Barr virus infection and a possibly increased risk of lymphoproliferative malignancy have been demonstrated. We describe here four patients with Epstein-Barr virus-associated hydroa vacciniforme treated with acyclovir/valacyclovir therapy with a good clinical response. The children were reported to have less fatigue, fewer eruptions, less scarring, and increased ability to spend time outdoors without provoking new eruptions. This was also in agreement with clinical observations. However, one patient progressed into an anaplastic lymphoma kinase-1-negative anaplastic large-cell lymphoma in the upper jaw. This was preceded by an increase in EBV viral load. Acyclovir/valacyclovir therapy is a safe treatment. Further studies are required to confirm these results.
Subject(s)
Acyclovir/analogs & derivatives , Acyclovir/therapeutic use , Antiviral Agents/therapeutic use , Epstein-Barr Virus Infections/drug therapy , Hydroa Vacciniforme/drug therapy , Hydroa Vacciniforme/virology , Valine/analogs & derivatives , Child , Child, Preschool , DNA, Viral/analysis , Drug Therapy, Combination , Epstein-Barr Virus Infections/diagnosis , Female , Herpesvirus 4, Human/genetics , Humans , Hydroa Vacciniforme/diagnosis , Jaw Diseases/virology , Lymphoma, Large B-Cell, Diffuse/virology , Male , Oral Ulcer/virology , Valacyclovir , Valine/therapeutic useABSTRACT
Herpes zoster (HZ, also known as shingles) is caused by the reactivation of a dormant varicella zoster virus and can be a source of significant morbidity. Oral manifestations can include vesicular eruptions of the mucosa, osteonecrosis with tooth loss, and postherpetic neuralgia (PHN). This article discusses treatment for trigeminal nerve involvement with herpes zoster, as well as for the painful syndrome PHN.
Subject(s)
Herpes Zoster/prevention & control , Mouth Diseases/virology , Neuralgia, Postherpetic/prevention & control , Osteonecrosis/virology , Trigeminal Neuralgia/virology , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , Herpes Zoster/complications , Herpes Zoster/therapy , Herpes Zoster Vaccine/therapeutic use , Humans , Jaw Diseases/prevention & control , Jaw Diseases/therapy , Jaw Diseases/virology , Male , Middle Aged , Mouth Diseases/etiology , Mouth Diseases/therapy , Neuralgia, Postherpetic/therapy , Neuralgia, Postherpetic/virology , Osteonecrosis/prevention & control , Osteonecrosis/therapy , Trigeminal Neuralgia/prevention & control , Trigeminal Neuralgia/therapyABSTRACT
Here we present a case of velopharyngeal palsy. An 18-year-old man had hyperemia in his left conjunctivum. One or two weeks later he experienced nasal speech and difficulty in swallowing. General physical examination was normal. The only abnormal neurological finding was palato-pharyngeal paralysis on the right side. MRI of the head and neck had no abnormalities. Acute and convalescent sera showed no rise in viral antibody titer. CSF examination was normal except for the increased IgG% and IgG.albumin index. Treatment consisted of glycerol and steroid, and his symptom improved within two or three weeks. We think immunological mechanism is important because CSF examination showed increased IgG% and IgG.albumin index in our case. Acquired and isolated velopharyngeal palsy is uncommon. Only 26 cases have been reported so far. This is the first case in Japan. The disease has some characteristics. This occurs in childhood and adolescence. Onset is sudden, consisting in rhinolalia and dysphagia. On examination there is asymmetry of the pharynx and deviation of the uvula contralateral to the affected side. There is no other neurological abnormalities. Complete spontaneous recovery is usual. In some cases viral infection is the cause, but in most cases the cause is unknown. In contrast, the disease with both acquired velopharyngeal palsy and vocal cord palsy is relatively common. This occurs in the middle aged or elderly people. In addition to dysphagia and hoarse voice, this disease often accompanies neurological abnormalities such as other cranial nerve palsy and meningitis, fever, and pain in the pharyngeal region. In most cases viral infection is the cause.
Subject(s)
Jaw Diseases/immunology , Palate, Soft , Paralysis/immunology , Pharyngeal Diseases/immunology , Adolescent , Antibodies, Viral/analysis , Humans , Immunoglobulin G/cerebrospinal fluid , Jaw Diseases/virology , Male , Paralysis/virology , Pharyngeal Diseases/virologyABSTRACT
In order to investigate the relationship between Epstein-Barr virus (EBV) latent infection and histogenesis of odontogenic disorders, in situ hybridization for EBV-encoded small RNA (EBER) was applied to the paraffin sections of ameloblastoma, dentigerous cyst, and odontogenic keratocyst. Eight cases (15%) of 53 ameloblastomas showed scattered signals for EBER in the parenchymal cells, whereas no reaction of EBER transcript was observed in the non-neoplastic cystic lesions. In the ameloblastoma, the follicular and plexiform types revealed the signals in the nuclei, but cystic, acanthomatous, granular, and basal cell types exhibited no reaction with EBER. The distribution of the signals without monoclonarity indicated that ameloblastoma cells may exclude EBV genomes or inactivate EBER-encoded genes. The results suggested that EBV participates as one of the transforming factors in the occurrence of ameloblastoma.
