Hydroa Vacciniforme with Mucosal Involvement and Recalcitrant Periodontitis and Multiple Virus Re-activators after Sun-exposure

Abstract

An 8-year-old boy presented with hydroa vacciniforme with recurrent oral mucosal ulcers and treatment-resistant gingivitis/periodontitis. Symptoms of oral mucosal involvement and gingivitis/periodontitis mirrored the severity of the skin lesions in sun-exposed areas. Although Epstein-Barr virus was negative in the skin lesions, Epstein-Barr virus DNA was detected in the gingival lesions when skin disease activity increased. Human herpes viruses-6 and -7 were also positive in the gingival lesions. Notably, human parvovirus B19 DNA was detected in both skin and gingival lesions. Impairment of systemic immunity was not detected. This report describes a rare case of hydroa vacciniforme with mucosal involvement and periodontal disease accompanied by multiple local virus re-activation.

Juvenile Spring Eruption Associated With Parvovirus B19 Infection

“…To our knowledge, PVB19 has only once been reported in association with a photodermatosis. In that report, an 8-year-old boy had hydroa vacciniforme and oral mucosal ulcers and gingivitis . Interestingly, several viruses (EBV, human herpesvirus 6 and 7, and PVB19) were found in the patient´s mucosa, but only PVB19 was detected in the skin lesions of sun-exposed areas.…”

Extensive hydroa vacciniforme

“…1,2,5 According to some reports, the oral mucosa can also be affected. 6 The disease may relapse in outbreaks; however, after puberty, these outbreaks become sparser.…”

Chronic Active Epstein-Barr Virus Infection-Associated Hydroa Vacciniforme-Like Eruption and Behçet's-Like Orogenital Ulcers

“…The clinical pattern of orogenital ulcers which were highly associated with HV-like eruption suggests a close link between these lesions. Co-existing oral and buccal ulcers with HV-like eruption have been reported rarely; indeed, there has to our knowledge been no report of a co-existing genital ulcer [16,21]. EBV-associated genital ulcer cases have been reported as a feature of primary EBV infection presenting as transient, relatively large and deep necrotic ulcers.…”