Cutaneous manifestations associated with HTLV‐1 infection

Abstract

Skin lesions are frequent in human T-cell lymphotropic virus type 1 (HTLV-1) infection and may constitute an alert for the diagnosis of this condition. The most severe skin diseases related to this virus are adult T-cell leukemia/lymphoma (ATLL), an aggressive form of leukemia/lymphoma that fails to respond to chemotherapy, and infective dermatitis associated with HTLV-1 (IDH), a severe and recurrent form of eczema occurring in childhood. ATLL affects the skin in 43-72% of cases. In this review, the clinical, histopathological and immunohistochemical aspects of ATLL and IDH will be discussed, as well as the differential diagnoses, giving particular focus to the primary cutaneous ATLL. IDH may progress to HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and to ATLL. Adult onset IDH and reactional and inflammatory dermatoses found in carriers and also in patients with HAM/TSP will be considered. Other dermatological diseases that occur more frequently in HTLV-1-infected individuals such as xerosis, acquired ichthyosis, seborrheic dermatitis and infectious and parasitic dermatoses will also be discussed.

Adult T-Cell Leukemia/Lymphoma

“…27 Rarely, cells can be positive for CD15 and may resemble Hodgkin disease. 27 High Ki-67 (proliferation index) is associated with worse outcome. 27 CYTOGENETICS AND MOLECULAR STUDIES Karyotype in ATLL is complex and without any characteristic abnormality, particularly in the acute forms.…”

“…Adult T-cell leukemias/lymphomas with double-positive T cells (CD4 þ , CD8 þ ) and only CD8 þ T lymphocytes have also been described; the former are associated with decreased survival, as reported in isolated case reports. 5,23,27,28 Adult T-cell leukemia/lymphoma cases with CD30 þ ALCL morphology are anaplastic lymphoma kinase 1 negative. 27 Rarely, cells can be positive for CD15 and may resemble Hodgkin disease.…”

“…5,23,27,28 Adult T-cell leukemia/lymphoma cases with CD30 þ ALCL morphology are anaplastic lymphoma kinase 1 negative. 27 Rarely, cells can be positive for CD15 and may resemble Hodgkin disease. 27 High Ki-67 (proliferation index) is associated with worse outcome.…”

“…27 High Ki-67 (proliferation index) is associated with worse outcome. 27 CYTOGENETICS AND MOLECULAR STUDIES Karyotype in ATLL is complex and without any characteristic abnormality, particularly in the acute forms. The abnormalities include aneuploidy (þ3, þ7, þ21, ÀX, ÀY), abnormalities of 3p, and translocations involving 14q11 and 14q32 sites of TCR(alpha) and TCR(delta) genes, respectively.…”

Linfoma anaplástico de células grandes CD30 positivo cutáneo primario: reporte de un caso

“…Queremos resaltar la importancia de solicitar la serología de HTLV-1 debido a que la leucemia-linfoma de células T del adulto asociada a HTLV-1 puede Patología e inmunohistoquímica Ausencia de expresión de ALK-1 Expresan ALK-1 la mayoría de las veces Linfoma anaplástico de células grandes cutáneo primario -C. Navarrete-Dechent et al simular clínica e histopatológicamente un LAC-GPC; la primera presenta un tratamiento, curso y pronóstico completamente diferente y ominoso y debe siempre considerarse en el diagnóstico diferencial de cualquier LCCT 10,11 . Se debe solicitar una TAC-TAP con contraste para evaluar compromiso extra-cutáneo, esto debido a que hasta 10-13% de los pacientes tendrá compromiso sistémico (incluyendo las adenopatías regionales) 1,5 .…”