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Rakita U, Kaundinya T, Guraya A, Nelson K, Maner B, Manjunath J, Schwartzman G, Lane B, Silverberg JI. Associations between onychomycosis and COVID-19 clinical outcomes: a retrospective cohort study from a US metropolitan center. Arch Dermatol Res 2022; 314:897-902. [PMID: 34773138 PMCID: PMC8589097 DOI: 10.1007/s00403-021-02299-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/15/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022]
Abstract
Little is known about the relationship of COVID-19 outcomes with onychomycosis. We investigated the relationship of onychomycosis with COVID-19 outcomes. A retrospective cohort study was performed on SARS-CoV-2 positive adult outpatients or inpatients who had onychomycosis and other skin diseases. Overall, 430 adults were identified with SARS-CoV-2 and a skin disease, including 98 with diagnosed onychomycosis. In bivariable logistic regression models, onychomycosis was associated with increased hospitalization {odds ratio(OR) [95% confidence interval (CI)]: 3.56 [2.18-5.80]}, initial inpatient vs. outpatient visits (OR [95% CI]: 2.24 [1.35-3.74]), use of oxygen therapy (OR [95% CI]: 2.77 [1.60-4.79]), severe-critical vs. asymptomatic-mild severity (OR [95% CI]: 2.28 [1.32-3.94]), and death (OR [95% CI]: 7.48 [1.83-30.47]) from COVID-19, but not prolonged hospitalization (OR [95% CI]: 1.03 [0.47-2.25]). In multivariable models adjusting for socio-demographics, comorbidities, and immunosuppressant medication use, the associations with onychomycosis remained significant for hospitalization, inpatient visits, oxygen therapy, severe-critical COVID-19. Onychomycosis was a significant independent risk factor for COVID-19 severity, hospitalization, and receiving supplemental oxygen therapy.
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Affiliation(s)
- Uros Rakita
- Chicago Medical School, Rosalind Franklin University, North Chicago, IL, 60064, USA
| | - Trisha Kaundinya
- Northwestern Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Armaan Guraya
- Midwestern University Chicago College of Osteopathic Medicine, Chicago, IL, 60515, USA
| | - Kamaria Nelson
- Department of Dermatology, George Washington School of Medicine, Washington, DC, 20052, USA
| | - Brittany Maner
- Ross University School of Medicine, St. Michael, BB11093, Barbados
| | - Jaya Manjunath
- Department of Dermatology, George Washington School of Medicine, Washington, DC, 20052, USA
| | - Gabrielle Schwartzman
- Department of Dermatology, George Washington School of Medicine, Washington, DC, 20052, USA
| | - Brittany Lane
- Michigan State University College of Human Medicine, East Lansing, MI, 48824, USA
| | - Jonathan I Silverberg
- Department of Dermatology, George Washington School of Medicine, Washington, DC, 20052, USA.
- George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.
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Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru. Pathogens 2021; 10:pathogens10030260. [PMID: 33668710 PMCID: PMC7996293 DOI: 10.3390/pathogens10030260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 01/13/2023] Open
Abstract
Background. Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. (2) Methods. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1 was assessed using ELISA (HTLV I + II ELISA recombinant v.4.0, Wiener lab, Rosario, Argentina). Positive cases were confirmed by Western Blot and HTLV-1 proviral load. (3) Results. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs 26.8 [SD 6.3]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of HTLV infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). (4) Conclusion. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.
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Abstract
Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell lymphoma caused by the human T-lymphotropic virus type-1 (HTLV-1). The skin is affected in approximately half of ATLL patients, and it may be the first manifestation of the disease. The skin lesions of ATLL are polymorphous, and depending on the type of skin eruption, it is possible to predict the prognosis of the disease. Besides specific skin lesions, other non-specific lesions and increased risk of cutaneous and systemic infections are observed. In this article, we describe the different skin lesions of ATLL patients (specific, non-specific, and infectious lesions), the different histopathological patterns, and the association of clinicopathological characteristics with prognosis. Recognition of ATLL skin lesions is essential for the correct management and the search for the virus, even in non-endemic regions, where global migration may bring HTLV-1 infected individuals.
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Affiliation(s)
- Denis Miyashiro
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
| | - Jose Antonio Sanches
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
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Verdonck K. Epidemiological and clinical aspects of human T-cell leukemia virus infection types 1 and 2: an introduction. Semin Diagn Pathol 2019; 37:79-80. [PMID: 31085040 DOI: 10.1053/j.semdp.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Weiler N, Mayer EF, Kazlouskaya V, Bamgbola OF, Banniettis N, Heilman E, Glick SA. Infective dermatitis associated with HTLV-1 infection in a girl from Trinidad: Case report and review of literature. Pediatr Dermatol 2019; 36:e12-e16. [PMID: 30338553 DOI: 10.1111/pde.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Infective dermatitis (ID) associated with Human T-cell leukemia virus type-1 (HTLV-1) is a rare form of severe superinfected eczema seen mostly in the Caribbean islands and Latin America. Although rapid response to antibiotic treatment is observed, patients should be monitored for development of complications associated with this retroviral infection, including T-cell leukemia/lymphoma (ATLL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Infective dermatitis is rarely seen in the United States and therefore may be under-recognized by physicians unfamiliar with this condition. Herein, we present an additional case report of an ID associated with HTLV-1 in an 11-year-old girl from Trinidad.
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Affiliation(s)
- Nicole Weiler
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Erick F Mayer
- Department of Pediatric Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | | | - Oluwatoyin F Bamgbola
- Department of Pediatric Nephrology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Natalie Banniettis
- Department of Pediatric Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Edward Heilman
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Sharon A Glick
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
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