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Kaposi varicelliform eruption
P2502
P2504
Infective dermatitis associated with HTLV-II: A case report Marilia Brasil Xavier, University of State of Para´, Bele´m, Para´, Brazil; Alena Margareth Darwich Mendes, University of State of Para´, Bele´m, Para´, Brazil; Ana Clara Yamada, Federal University of Para´, Bele´m, Para´, Brazil; Antonio Valinoto, Federal University of Para´, Bele´m, Para´, Brazil; Francisca Regina Oliveira Carneiro, University of State of Para´, Bele´m, Para´, Brazil
Kaposi varicelliform eruption Tiago Torres, MD, Servic¸o de Dermatologia Hospital Santo Anto´nio, Porto, Portugal; Aristoteles Rosmaninho, MD, Servic¸o de Dermatologia Hospital de Santo Anto´nio, Porto, Portugal; Madalena Sanches, MD, Servic¸o de Dermatologia ´ nio, Porto, Portugal; Manuela Selores, MD, Servic¸o de Hospital Santo Anto Dermatologia Hospital Santo Anto´nio, Porto, Portugal
Introduction: Human T-cell lymphotropic virus (HTLV) types I and II are endemic in the Amazon region. The main known transmission routes are sexual contact, exposure to contaminated blood components, and vertical transmission. Type I is associated both with a group of hematologic disorders known as adult T-cell leukemia/lymphoma (ATLL) and a group of neurologic conditions known altogether as the HTLV-1 neurologic complex, of which the most common is the HTLV1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-II is still not clearly associated with any disease, although recently some authors had proposed the relationship with a neurologic disease similar to peripheral neuropathy.
Kaposi varicelliform eruption is a potentially fatal widespread cutaneous infection caused by herpes simplex and certain other virus that arises in preexisting skin conditions, most commonly atopic dermatitis. We report a case of a 1-year-old male with atopic dermatitis who presented with extensive vesicular eruption affecting the face and trunk, associated with fever, malaise, and irritability. The diagnosis of Kaposi varicelliform eruption was made based on clinical features, tzanck smear examination and polymerase chain reaction assay of the vesicle content. The patient responded adequately to oral acyclovir therapy without any complications. Kaposi varicelliform eruption is a rare condition and severity varies from mild transient disease to a fulminating fatal disorder involving the visceral organs. Mortality ranges from 1% to 9%, with reported rates as high as 75% before the advent of effective antiviral drugs. Antiviral treatment is very effective and should be instituted without delay to avoid significant morbidity and mortality. Therefore, a high clinical suspicion for Kaposi varicelliform eruption should be maintained in children with atopic dermatitis who have a vesicular eruption.
Case report: A 13-year-old female with a history since she was 6 months old of erythematous scamous plaque predominantly in the scalp, face, retroauricular fold without pruritus had been observed. During her whole childhood, many respiratory infections were related, all of them treated with antibiotic with good response. Actually, the same lesions are observed including abdominal lesions. An ELISA test to HTLVI/II was performed which resulted positive. PCR test confirmed the presence of HTLV-II. Conclusion: Until now no other case of infective dermatitis was related associated with HTLV-II so this can be the first description of this relation.
Commercial support: None identified.
Commercial support: None identified.
P2505
P2503 Age-adjusted incidence of anogenital warts in Qatar in the year 2003 Sharifa Aldosari, MD, MBBS, Hamad Medical, Doha, Qatar; Hassan Riad, MD, MBBCh, Hamad Medical, Doha, Qatar
Atypical pityriasis rosea in a pregnant woman in the setting of herpes simplex virus type 2 reactivation Maria Jo~ao Cruz, MD, Hospital de S~ao Jo~ao, Dermatology and Venereology Department, Porto, Portugal; Ana Luisa Cunha, MD, Hospital de S~ao Jo~ao, Pathology Department, Porto, Portugal; Filomena Azevedo, MD, Hospital de S~ao Jo~ao, Dermatology and Venereology Department, Porto, Portugal; Teresa Baudrier, MD, Hospital de S~ao Jo~ao, Dermatology and Venereology Department, Porto, Portugal Background: Pityriasis rosea (PR) is a relatively common skin disorder of still unknown cause, but many epidemiologic, clinical, and experimental features suggest an infectious etiology. The search for a microorganism continues and most speculations now centers on a viral etiology. In its typical form it is easily recognizable, however, atypical forms are found in a considerable proportion of patients (20%) and can pose diagnostic problems.
Conclusion: We concluded that the incidence of genital warts in Qatar is lower than the majority of the announced figures for other countries in the region as well as countries with increased incidence of sexually transmitted diseases. We need to continue reporting and registering patients with genital warts and to update calculations for incidence. We recommend adoption of a new policy of vaccination against oncogenic HPV for the population at risk.
Case report: A 28-year-old pregnant woman in the last trimester came to our department because of the appearance of grouped pruriginous papulovesicles on an erythematous base located in the right side of the hip. Swab specimens from vesicles revealed HSV type 2 DNA by polymerase chain reaction (PCR). Serology for that virus was positive only for IgG antibodies in the beginning of pregnancy, and was positive for both IgM and IgG antibodies at our first examination. Laboratory evaluation was otherwise unremarkable. Two days after, a well demarcated erythematous round asymptomatic patch, 3 cm in diameter, and a fine central scaliest collarette aroused in her left thigh, right next to the knee. In the following days, identical but smaller lesions blossomed in both thighs. At that time, the herpetic lesion was clearly in a healing process. She was otherwise healthy and denied similar eruptions before. Two skin biopsies were performed in the first patch: PCR analysis demonstrated HSV type 2 and histologic examination was compatible with PR. No treatment was prescribed and the eruption completely subsided within approximately 8 weeks. Delivery was uneventful and the baby was perfectly healthy. Conclusion: This case emphasizes the theory proposed by Kempf et al that herpesvirus closely related to alfa-herpesviruses (such as HSV or VZV) may be the causative agent of PR. The spectrum of varying and contradictory data regarding an infectious etiology may represent the nature of PR (ie, it is probably a multifactorial disease that can be induced by various infectious agents). To our knowledge there are no reports in medical literature of PR associated with HSV reactivation. High level of suspicion and histologic examination are important and helpful for the diagnosis of atypical cases as the one reported.
Commercial support: None identified.
Commercial support: None identified.
Background: Genital HPV infection is the fastest spreading sexually transmitted infection; it is also a major cause of cervical carcinoma of females after an incubation period of 10 to 20 years. Epidemiologic studies from the gulf region are sluggish. The aim of this study is to detect the age adjusted incidence of genital warts in Qatar in the year 2003. Methods: The study was done in the dermatology OPD of Hamad Medical (the major hospital in Doha). All patients with genital warts in the year 2003 were registered. Detailed history and thorough examination was done for each case. Biopsies were performed to confirm the diagnosis in selected cases. Descriptive statistics was done using Statistical Package for Social Sciences version 10. The crude incidence equals the number of patient with genital wart reported divided by the total number of population in Qatar in 2003. Age-adjusted incidence equals the crude incidence multiplied by the population weight. Results: The calculated crude incidence was 9.54 per 100000 per year and the calculated age adjusted incidence was 9.706 per 100000 per year.
MARCH 2010
J AM ACAD DERMATOL
AB89
P2504
Infective dermatitis associated with HTLV-II: A case report Marilia Brasil Xavier, University of State of Para´, Bele´m, Para´, Brazil; Alena Margareth Darwich Mendes, University of State of Para´, Bele´m, Para´, Brazil; Ana Clara Yamada, Federal University of Para´, Bele´m, Para´, Brazil; Antonio Valinoto, Federal University of Para´, Bele´m, Para´, Brazil; Francisca Regina Oliveira Carneiro, University of State of Para´, Bele´m, Para´, Brazil
Kaposi varicelliform eruption Tiago Torres, MD, Servic¸o de Dermatologia Hospital Santo Anto´nio, Porto, Portugal; Aristoteles Rosmaninho, MD, Servic¸o de Dermatologia Hospital de Santo Anto´nio, Porto, Portugal; Madalena Sanches, MD, Servic¸o de Dermatologia ´ nio, Porto, Portugal; Manuela Selores, MD, Servic¸o de Hospital Santo Anto Dermatologia Hospital Santo Anto´nio, Porto, Portugal
Introduction: Human T-cell lymphotropic virus (HTLV) types I and II are endemic in the Amazon region. The main known transmission routes are sexual contact, exposure to contaminated blood components, and vertical transmission. Type I is associated both with a group of hematologic disorders known as adult T-cell leukemia/lymphoma (ATLL) and a group of neurologic conditions known altogether as the HTLV-1 neurologic complex, of which the most common is the HTLV1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-II is still not clearly associated with any disease, although recently some authors had proposed the relationship with a neurologic disease similar to peripheral neuropathy.
Kaposi varicelliform eruption is a potentially fatal widespread cutaneous infection caused by herpes simplex and certain other virus that arises in preexisting skin conditions, most commonly atopic dermatitis. We report a case of a 1-year-old male with atopic dermatitis who presented with extensive vesicular eruption affecting the face and trunk, associated with fever, malaise, and irritability. The diagnosis of Kaposi varicelliform eruption was made based on clinical features, tzanck smear examination and polymerase chain reaction assay of the vesicle content. The patient responded adequately to oral acyclovir therapy without any complications. Kaposi varicelliform eruption is a rare condition and severity varies from mild transient disease to a fulminating fatal disorder involving the visceral organs. Mortality ranges from 1% to 9%, with reported rates as high as 75% before the advent of effective antiviral drugs. Antiviral treatment is very effective and should be instituted without delay to avoid significant morbidity and mortality. Therefore, a high clinical suspicion for Kaposi varicelliform eruption should be maintained in children with atopic dermatitis who have a vesicular eruption.
Case report: A 13-year-old female with a history since she was 6 months old of erythematous scamous plaque predominantly in the scalp, face, retroauricular fold without pruritus had been observed. During her whole childhood, many respiratory infections were related, all of them treated with antibiotic with good response. Actually, the same lesions are observed including abdominal lesions. An ELISA test to HTLVI/II was performed which resulted positive. PCR test confirmed the presence of HTLV-II. Conclusion: Until now no other case of infective dermatitis was related associated with HTLV-II so this can be the first description of this relation.
Commercial support: None identified.
Commercial support: None identified.
P2505
P2503 Age-adjusted incidence of anogenital warts in Qatar in the year 2003 Sharifa Aldosari, MD, MBBS, Hamad Medical, Doha, Qatar; Hassan Riad, MD, MBBCh, Hamad Medical, Doha, Qatar
Atypical pityriasis rosea in a pregnant woman in the setting of herpes simplex virus type 2 reactivation Maria Jo~ao Cruz, MD, Hospital de S~ao Jo~ao, Dermatology and Venereology Department, Porto, Portugal; Ana Luisa Cunha, MD, Hospital de S~ao Jo~ao, Pathology Department, Porto, Portugal; Filomena Azevedo, MD, Hospital de S~ao Jo~ao, Dermatology and Venereology Department, Porto, Portugal; Teresa Baudrier, MD, Hospital de S~ao Jo~ao, Dermatology and Venereology Department, Porto, Portugal Background: Pityriasis rosea (PR) is a relatively common skin disorder of still unknown cause, but many epidemiologic, clinical, and experimental features suggest an infectious etiology. The search for a microorganism continues and most speculations now centers on a viral etiology. In its typical form it is easily recognizable, however, atypical forms are found in a considerable proportion of patients (20%) and can pose diagnostic problems.
Conclusion: We concluded that the incidence of genital warts in Qatar is lower than the majority of the announced figures for other countries in the region as well as countries with increased incidence of sexually transmitted diseases. We need to continue reporting and registering patients with genital warts and to update calculations for incidence. We recommend adoption of a new policy of vaccination against oncogenic HPV for the population at risk.
Case report: A 28-year-old pregnant woman in the last trimester came to our department because of the appearance of grouped pruriginous papulovesicles on an erythematous base located in the right side of the hip. Swab specimens from vesicles revealed HSV type 2 DNA by polymerase chain reaction (PCR). Serology for that virus was positive only for IgG antibodies in the beginning of pregnancy, and was positive for both IgM and IgG antibodies at our first examination. Laboratory evaluation was otherwise unremarkable. Two days after, a well demarcated erythematous round asymptomatic patch, 3 cm in diameter, and a fine central scaliest collarette aroused in her left thigh, right next to the knee. In the following days, identical but smaller lesions blossomed in both thighs. At that time, the herpetic lesion was clearly in a healing process. She was otherwise healthy and denied similar eruptions before. Two skin biopsies were performed in the first patch: PCR analysis demonstrated HSV type 2 and histologic examination was compatible with PR. No treatment was prescribed and the eruption completely subsided within approximately 8 weeks. Delivery was uneventful and the baby was perfectly healthy. Conclusion: This case emphasizes the theory proposed by Kempf et al that herpesvirus closely related to alfa-herpesviruses (such as HSV or VZV) may be the causative agent of PR. The spectrum of varying and contradictory data regarding an infectious etiology may represent the nature of PR (ie, it is probably a multifactorial disease that can be induced by various infectious agents). To our knowledge there are no reports in medical literature of PR associated with HSV reactivation. High level of suspicion and histologic examination are important and helpful for the diagnosis of atypical cases as the one reported.
Commercial support: None identified.
Commercial support: None identified.
Background: Genital HPV infection is the fastest spreading sexually transmitted infection; it is also a major cause of cervical carcinoma of females after an incubation period of 10 to 20 years. Epidemiologic studies from the gulf region are sluggish. The aim of this study is to detect the age adjusted incidence of genital warts in Qatar in the year 2003. Methods: The study was done in the dermatology OPD of Hamad Medical (the major hospital in Doha). All patients with genital warts in the year 2003 were registered. Detailed history and thorough examination was done for each case. Biopsies were performed to confirm the diagnosis in selected cases. Descriptive statistics was done using Statistical Package for Social Sciences version 10. The crude incidence equals the number of patient with genital wart reported divided by the total number of population in Qatar in 2003. Age-adjusted incidence equals the crude incidence multiplied by the population weight. Results: The calculated crude incidence was 9.54 per 100000 per year and the calculated age adjusted incidence was 9.706 per 100000 per year.
MARCH 2010
J AM ACAD DERMATOL
AB89