scholarly journals DERMATITE INFECCIOSA NO ADULTO: DOENÇA DE DIFÍCIL DIAGNÓSTICO E IMPORTANTE MANEJO CLÍNICO

2017 ◽  
Vol 75 (1) ◽  
Author(s):  
Priscila Silva Correia Correia Pri ◽  
Fernanda Cabral Cabral Fe ◽  
Gabriela Higino de Souza Higino Gabi ◽  
Miguel Barrella Neto Barrella Miguel ◽  
Daniel Lago Obadia Lago Daniel ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Contact Dermatitis ◽  
Seborrheic Dermatitis ◽  
Spastic Paraparesis ◽  
Adult Onset ◽  
Cell Leukemia ◽  
Distinct Entity ◽  
Adult T Cell Leukemia ◽  
Dermatitis Contact

ResumoA dermatite infecciosa (DI) é uma dermatite grave, crônica e recidivante, descrita como entidade distinta por Sweet em 1966, e associada a infecção pelo HTLV-1 em 1990 por La Grenade e cols. Embora a maioria dos casos descritos tenha início na infância, casos de dermatite infecciosa em adultos tem sido relatados. O quadro dermatológico mimetiza condições comuns como dermatite seborreica, dermatite atópica, dermatite de contato, impetigo e micose fungoide. Em países endêmicos para a infecção por HTLV-1, como o Brasil, é imprescindível que a dermatite infecciosa seja lembrada como diagnóstico diferencial, nestes casos. A identificação precoce é importante a fim de evitar adisseminação e proporcionar acompanhamento e tratamento adequados de possíveis complicações associadas ao vírus, como a mielopatia associada ao HTLV ou paraparesia espástica tropical (HAM/TSP), e a leucemia/linfoma de células T do adulto (ATLL).Relatamos o caso de 2 pacientes do sexo feminino com dermatite infecciosa de início na idade adulta. Para enriquecimento do caso, também apresentamos as fotos da filha de uma das pacientes, com mesmo diagnóstico. Abstract:Infectious dermatitis (ID) is a severe, chronic and relapsing dermatitis, described as a distinct entity by Sweet in 1966 and associated with HTLV-1 in 1990 by La Grenade et al. Although most reported cases have onset in childhood, cases of infectious dermatitis in adults have been reported. The dermatological framework mimics common conditions such as seborrheic dermatitis, atopic dermatitis, contact dermatitis, impetigo and mycosis fungoides. In endemic countries for HTLV-1, like Brazil, it is essential that the infectious dermatitis is remembered as a differential diagnosis in these cases. Early diagnosis is important to prevent the dissemination and provide appropriate monitoring and treatment of possible complications associated with the virus, such as HTLV-1 associated myelopathy or tropical spastic paraparesis (HAM / TSP), and Adult T-cell leukemia / lymphoma (ATLL). We report two female patients with adult-onset ID. In order to enrich the report, we also presented the daughter's photos from one of the patients, with the same diagnosis.

Eczematous Disorders, Atopic Dermatitis, and Ichthyoses

2018 ◽  
Author(s):  
Seth R Stevens
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Contact Dermatitis ◽  
Seborrheic Dermatitis ◽  
Inflammatory Dermatosis ◽  
Poison Ivy ◽  
Eczematous Dermatitis ◽  
Total Body ◽  
Allergic Contact ◽  
Nummular Eczema

This review describes eczematous dermatitis, or eczema, a skin disease that is characterized by erythematous vesicular, weeping, and crusting patches; atopic dermatitis, a common chronic inflammatory dermatosis that generally begins in infancy; and the ichthyoses, a group of diseases of cornification that are characterized by excessive scaling. The purpose of this review is to examine the major variants, epidemiology, etiology, diagnosis, differential diagnosis, and treatment of these dermatologic diseases. Figures depict chronic eczematous dermatitis, allergic contact dermatitis to poison ivy, seborrheic dermatitis, nummular eczema, acute eczematous patches, lichenified patches that appear after chronic rubbing of eczematous patches, erythroderma (total body erythema), and marked scaling (acquired ichthyosis). Tables list the diagnostic criteria for atopic dermatitis and the differential diagnosis of atopic dermatitis. This review contains 9 highly rendered figures, 2 tables, and 88 references.

Eczematous Disorders, Atopic Dermatitis, and Ichthyoses

2016 ◽  
Author(s):  
Seth R Stevens
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Contact Dermatitis ◽  
Seborrheic Dermatitis ◽  
Inflammatory Dermatosis ◽  
Poison Ivy ◽  
Eczematous Dermatitis ◽  
Total Body ◽  
Allergic Contact ◽  
Nummular Eczema

This review describes eczematous dermatitis, or eczema, a skin disease that is characterized by erythematous vesicular, weeping, and crusting patches; atopic dermatitis, a common chronic inflammatory dermatosis that generally begins in infancy; and the ichthyoses, a group of diseases of cornification that are characterized by excessive scaling. The purpose of this review is to examine the major variants, epidemiology, etiology, diagnosis, differential diagnosis, and treatment of these dermatologic diseases. Figures depict chronic eczematous dermatitis, allergic contact dermatitis to poison ivy, seborrheic dermatitis, nummular eczema, acute eczematous patches, lichenified patches that appear after chronic rubbing of eczematous patches, erythroderma (total body erythema), and marked scaling (acquired ichthyosis). Tables list the diagnostic criteria for atopic dermatitis and the differential diagnosis of atopic dermatitis. This review contains 9 highly rendered figures, 2 tables, and 88 references.

Eczematous Disorders, Atopic Dermatitis, and Ichthyoses

2018 ◽  
Author(s):  
Seth R Stevens
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Contact Dermatitis ◽  
Seborrheic Dermatitis ◽  
Inflammatory Dermatosis ◽  
Poison Ivy ◽  
Eczematous Dermatitis ◽  
Total Body ◽  
Allergic Contact ◽  
Nummular Eczema

This review describes eczematous dermatitis, or eczema, a skin disease that is characterized by erythematous vesicular, weeping, and crusting patches; atopic dermatitis, a common chronic inflammatory dermatosis that generally begins in infancy; and the ichthyoses, a group of diseases of cornification that are characterized by excessive scaling. The purpose of this review is to examine the major variants, epidemiology, etiology, diagnosis, differential diagnosis, and treatment of these dermatologic diseases. Figures depict chronic eczematous dermatitis, allergic contact dermatitis to poison ivy, seborrheic dermatitis, nummular eczema, acute eczematous patches, lichenified patches that appear after chronic rubbing of eczematous patches, erythroderma (total body erythema), and marked scaling (acquired ichthyosis). Tables list the diagnostic criteria for atopic dermatitis and the differential diagnosis of atopic dermatitis. This review contains 9 highly rendered figures, 2 tables, and 88 references.

scholarly journals Germinal epimutation of Fragile Histidine Triad (FHIT) gene is associated with progression to acute and chronic adult T-cell leukemia diseases

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Marcia Bellon ◽  
Izabela Bialuk ◽  
Veronica Galli ◽  
Xue-Tao Bai ◽  
Lourdes Farre ◽  
...  
Keyword(s):  
T Cell ◽  
Tumor Suppressor ◽  
Spastic Paraparesis ◽  
Cellular Transformation ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Cell Leukemia Virus Type ◽  
Fragile Histidine Triad ◽  
Adult T Cell Leukemia ◽  
Human T Cell

Abstract Background Human T cell Leukemia virus type 1 (HTLV-I) is etiologically linked to adult T cell leukemia/lymphoma (ATL) and an inflammatory neurodegenerative disease called HTLV-I-associated myelopathy or tropical spastic paraparesis (HAM/TSP). The exact genetic or epigenetic events and/or environmental factors that influence the development of ATL, or HAM/TSP diseases are largely unknown. The tumor suppressor gene, Fragile Histidine Triad Diadenosine Triphosphatase (FHIT), is frequently lost in cancer through epigenetic modifications and/or deletion. FHIT is a tumor suppressor acting as genome caretaker by regulating cellular DNA repair. Indeed, FHIT loss leads to replicative stress and accumulation of double DNA strand breaks. Therefore, loss of FHIT expression plays a key role in cellular transformation. Methods Here, we studied over 400 samples from HTLV-I-infected individuals with ATL, TSP/HAM, or asymptomatic carriers (AC) for FHIT loss and expression. We examined the epigenetic status of FHIT through methylation specific PCR and bisulfite sequencing; and correlated these results to FHIT expression in patient samples. Results We found that epigenetic alteration of FHIT is specifically found in chronic and acute ATL but is absent in asymptomatic HTLV-I carriers and TSP/HAM patients’ samples. Furthermore, the extent of FHIT methylation in ATL patients was quantitatively comparable in virus-infected and virus non-infected cells. We also found that longitudinal HTLV-I carriers that progressed to smoldering ATL and descendants of ATL patients harbor FHIT methylation. Conclusions These results suggest that germinal epigenetic mutation of FHIT represents a preexisting mark predisposing to the development of ATL diseases. These findings have important clinical implications as patients with acute ATL are rarely cured. Our study suggests an alternative strategy to the current “wait and see approach” in that early screening of HTLV-I-infected individuals for germinal epimutation of FHIT and early treatment may offer significant clinical benefits.

Differential Diagnosis of Seborrheic Dermatitis

1986 ◽  
Vol 7 (7) ◽  
pp. 204-211
Author(s):  
Mary L. Williams
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Metabolic Diseases ◽  
Fungal Infections ◽  
Seborrheic Dermatitis ◽  
Local Therapy ◽  
Skin Condition ◽  
Unknown Etiology ◽  
Common Skin ◽  
Nutritional And Metabolic Diseases

Seborrheic dermatitis is a common skin condition of infancy of unknown etiology. The disorder is usually mild and responsive to therapy. In severe or atypical cases, a variety of other entities should be considered in the differential diagnosis. Atopic dermatitis, psoriasis, psoriasiform-id reaction, fungal infections, and irritant contact dermatitis can be differentiated on clinical grounds. Less common but more serious disorders, such as histiocytosis X, immunodeficiency disorders, and nutritional and metabolic diseases, may be considered in the child whose disease does not spontaneously resolve or respond satisfactorily to local therapy. Laboratory studies including skin biopsy may be helfpul in these cases. Seborrheic dermatitis is uncommon in children after infancy and before puberty. In this age group, scalp scaling is likely to be due to other causes, such as tinea capitis, atopic dermatitis, or psoriasis.

Case Report: HTLV-1–Induced Adult T-Cell Leukemia and Tropical Spastic Paresis

2021 ◽  
Author(s):  
Reece Rosenthal ◽  
Julika Kaplan ◽  
Mohammed Ahmed ◽  
Martha Mims ◽  
Jill E. Weatherhead
Keyword(s):  
T Cell ◽  
Lower Extremity ◽  
Spastic Paraparesis ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Lower Extremity Weakness ◽  
T Lymphotropic Virus ◽  
Adult T Cell Leukemia ◽  
Spastic Paresis

Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus endemic in many areas around the world. HTLV-1 can induce the development of adult T-cell leukemia (ATL) or myelopathy/tropical spastic paraparesis (HAM/TSP). We report a patient who presented to our outpatient clinic with massive splenomegaly, weight loss, urinary retention, and lower extremity weakness for the previous 3 years. The patient was found to have positive HTLV-1 by ELISA and Western blot from peripheral blood. Evaluation of the spleen demonstrated T-cell large granular lymphocyte leukemia consistent with ATL. In addition to progressive lower extremity weakness, hyperreflexia and clonus, cerebral spinal fluid was positive for HTLV-1 by ELISA and had a reversed CD4-to-CD8 ratio consistent with HAM/TSP. These findings suggest HTLV-1 induced ATL and HAM/TSP presenting simultaneously in the same patient.

scholarly journals HTLV-1 infection of myeloid cells: from transmission to immune alterations

Retrovirology ◽  
2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Brenda Rocamonde ◽  
Auriane Carcone ◽  
Renaud Mahieux ◽  
Hélène Dutartre
Keyword(s):  
T Cell ◽  
Leukemia Virus ◽  
Spastic Paraparesis ◽  
Myeloid Cells ◽  
Cell Types ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Cell Leukemia Virus Type ◽  
Adult T Cell Leukemia ◽  
Human T Cell

AbstractHuman T cell leukemia virus type 1 (HTLV-1), the etiological agent of adult T-cell leukemia/lymphoma (ATLL) and the demyelinating neuroinflammatory disease known as HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP), was the first human retrovirus to be discovered. T-cells, which represent the main reservoir for HTLV-1, have been the main focus of studies aimed at understanding viral transmission and disease progression. However, other cell types such as myeloid cells are also target of HTLV-1 infection and display functional alterations as a consequence. In this work, we review the current investigations that shed light on infection, transmission and functional alterations subsequent to HTLV-1 infection of the different myeloid cells types, and we highlight the lack of knowledge in this regard.

scholarly journals Human T-Cell Lymphotropic Virus Type-I (HTLV-I)-Associated Myelopathy/Tropical Spastic Paraparesis with Acute Type of Adult T-Cell Leukemia.

1995 ◽  
Vol 34 (11) ◽  
pp. 1130-1133 ◽  
Author(s):  
Yoshitaka FURUKAWA ◽  
Toshihide OKADOME ◽  
Mitsutoshi TARA ◽  
Kiyoshige NIINA ◽  
Shuji IZUMO ◽  
...  
Keyword(s):  
T Cell ◽  
Virus Type ◽  
Spastic Paraparesis ◽  
Tropical Spastic Paraparesis ◽  
Type I ◽  
Acute Type ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Adult T Cell Leukemia ◽  
Human T Cell

Existence of escape mutant in HTLV-I tax during the development of adult T-cell leukemia

Blood ◽  
2001 ◽  
Vol 97 (4) ◽  
pp. 987-993 ◽  
Author(s):  
Yoshitaka Furukawa ◽  
Ryuji Kubota ◽  
Mitsutoshi Tara ◽  
Shuji Izumo ◽  
Mitsuhiro Osame
Keyword(s):  
T Cell ◽  
Stop Codon ◽  
Spastic Paraparesis ◽  
Genetic Alterations ◽  
Host Immune System ◽  
Type I ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Adult T Cell Leukemia ◽  
Infected Cells

Abstract Although Tax protein is the main target of cytotoxic T lymphocyte (CTL) on human T-cell lymphotropic virus type I (HTLV-I)–infected cells, and Tax peptide 11 through 19 binding to HLA-A*02 has been shown to elicit a strong CTL response, there are patients with adult T-cell leukemia (ATL) bearing HLA-A*02. To explore whether there is genetic variation in HTLV-I tax that can escape CTL recognition during the development of ATL, the HTLV-I tax gene was sequenced in 55 patients with ATL, 61 patients with HTLV-I–associated myelopathy/tropical spastic paraparesis (HAM/TSP), and 62 healthy carriers, and it was correlated with the presence of HLA-A*02. First, a premature stop codon in the 5′ half of the tax gene that looses transactivation activity on the viral enhancer was observed in 3 patients with acute and 1 patient with chronic ATL. This stop codon was revealed to emerge after the viral transmission to the patient from sequence analysis in family members with ATL. Second, amino acid change in Tax peptide 11-19 was observed in 3 patients with ATL. CTL assays demonstrated that this altered Tax 11-19 peptide, observed in ATL patients with HLA-A*02, was not recognized by Tax 11-19–specific CTL. Two patients with ATL had large deletions in tax by sequencing, and 5 patients with ATL had deletions in HTLV-I by Southern blotting. These findings suggest that at some stage of ATL development, HTLV-I–infected cells that can escape the host immune system are selected and have a chance to accumulate genetic alterations for further malignant transformation, leading to acute ATL.

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