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Khader A, Shaan M, Balakrishnan S, Ambooken B, Muhammed K, Rajan U. Multifaceted adult T-cell leukemia/lymphoma in India: a case series. Indian J Dermatol 2015; 60:103. [PMID: 25657421 PMCID: PMC4318027 DOI: 10.4103/0019-5154.147846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Adult T-cell leukemia/lymphoma (ATL) is caused by human T-cell lymphotropic virus type-1 (HTLV-1). India is considered as a nonendemic region for HTLV-1. Recent upsurge of cases have been noted in southern parts of India. Aims and objectives: The objective was to describe skin manifestations in various types of ATL. Materials and Methods: Clinical examination, blood investigations, skin biopsies, lymph node biopsies, and immunohistochemistry were performed in five patients. Flow cytometry was performed in two cases. Results: Serological testing was positive for HTLV-1 in all patients. All patients presented with skin lesions. Rare presentations of molluscum contagiosum like papules, purpuric macules and plaques, hypopigmented macules and verrucous papules were seen. Dermatophytic infections occurred in two patients. Mucosal lesion was seen in one patient. Histological features include dermal lymphoid infiltrate with or without epidermotropism. Presence of epidermotropism did not correlate with the severity of disease. All patients except one succumbed to illness within few months to 1 year period. Conclusions: ATL manifest in myriad presentations and skin lesions are often the earliest manifestation. Cutaneous manifestations of ATL vary from subtle hypopigmented macules to florid nodular lesions, and HTLV-1 screening need to be carried out in all doubtful cases.
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Affiliation(s)
- Anza Khader
- Department of Dermatology, Government Medical College, Calicut, Kerala, India
| | - Mohamed Shaan
- Department of Medicine, Government Medical College, Calicut, Kerala, India
| | | | - Betsy Ambooken
- Department of Dermatology, Government Medical College, Calicut, Kerala, India
| | - Kunnummel Muhammed
- Department of Dermatology, Government Medical College, Calicut, Kerala, India
| | - Uma Rajan
- Department of Dermatology, Government Medical College, Calicut, Kerala, India
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Yazdanpanah MJ, Maleki M, Joneidi N, Khalighi AR, Azarpazhooh MR, Khajedaluee M, Tehranian F, Shahabi M, Esmaeil Khayami M, Livani F. Cutaneous Manifestations in HTLV-I Positive Blood Donors. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2013; 16:273-7. [PMID: 24470876 PMCID: PMC3881254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 12/20/2012] [Indexed: 10/26/2022]
Abstract
OBJECTIVE(S) Infection with the human T-cell lymphotrophic virus type-I (HTLV-I) is endemic in Mashhad, Iran. In our research we evaluated the relation between exposure to this infection and the occurrence of dermatologic manifestations. MATERIALS AND METHODS 100 blood donors, who were seropositive but asymptomatic for infection with HTLV-I, were selected as case group. They were identified by the Blood Transfusion Organization Mashhad via the ELISA test and documented by PCR. Another 100 blood donors, that were seronegative for HTLV-I via the ELISA test and who were matched to the case group for age, gender, and existence of systemic diseases, were considered as the controls. Dermatologic evaluations and skin biopsies were performed if deemed necessary, and the results were statistically analyzed. RESULTS 73% of the case and control groups were male, while 27% in each of these groups were female. The mean age in both groups was 40.96±11.94 years. The examination indicated that 58% of the case group and 37% of the control group had cutaneous manifestations (P<0.01). The most common diseases found in the case group were aphthous stomatitis, herpes labialis, and non-genital warts, while common diseases found in the control group were herpes labialis, aphthous stomatitis, and skin tag. The frequency of aphthous stomatitis, eczema, and non-genital warts in the case group were significantly more than the control group (P<0.05). Conclusion : Cutaneous diseases can be found more frequent in asymptomatic carriers of HTLV-I than those who are HTLV-I seronegative. The aphthous stomatitis, eczema, and non-genital warts are more prevalent in those infected by HTLV-I.
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Affiliation(s)
- Mohammad Javad Yazdanpanah
- Research centre for Cutaneous Leishmaniasis, Department of Dermatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Maleki
- Research centre for Cutaneous Leishmaniasis, Department of Dermatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasaibe Joneidi
- Research centre for Cutaneous Leishmaniasis, Department of Dermatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Khalighi
- Department of Internal Medicine ,Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Department of Neurology, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Khajedaluee
- Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farahnaz Tehranian
- Research Centre of Iranian Blood Transfusion Organization, Khorasan Razavi, Mashhad, Iran
| | - Majid Shahabi
- Research Centre of Iranian Blood Transfusion Organization, Khorasan Razavi, Mashhad, Iran
| | | | - Fatemeh Livani
- Research centre for Cutaneous Leishmaniasis, Department of Dermatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Chaudhari CN, Shah T, Misra RN. Prevalence of Human T Cell Leukaemia Virus amongst Blood Donors. Med J Armed Forces India 2011; 65:38-40. [PMID: 27408188 DOI: 10.1016/s0377-1237(09)80052-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 09/11/2007] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Human T cell leukaemia virus (HTLV) I/II are retroviruses implicated in transfusion transmitted infection. Present study was undertaken to assess seroprevalence of HTLV in voluntary blood donors along with pattern of blood utilisation. METHODS A total of 258 healthy blood donors who were free from infectious markers in transfusion as per current transfusion guidelines were enrolled. They were screened for HTLV-I/II antibodies by commercially available enzyme immuno assay (EIA) and their blood utilisation data was analysed. RESULT Five (1.9%) donors were found seropositive for HTLV-I/II of which 1.2 % were first time and 0.9% were repeat donors. Blood utilisation data revealed 20.9% and 38.8% units were utilised within 5 and 6-14 days of collection respectively. 45.9% recipients were transfused with single blood unit. 42.9% recipients were immunosuppressed due to underlying disease. CONCLUSION The high prevalence of HTLV in blood donors, coupled with single unit transfusion, use of fresh blood, non availability of acellular blood products and immunosuppression in recipients can lead to significant transfusion transmitted HTLV infection. We suggest judicious use of blood products and screening of blood donors in prevention of transfusion transmitted HTLV-I/II.
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Affiliation(s)
- C N Chaudhari
- Classified Specialist (Microbiology), INHS Jeevanti, Vasco-Da-Gama-403802
| | - T Shah
- Ex-Post Graduate Student (Microbiology), INHS Asvini, Colaba, Mumbai.-400005
| | - R N Misra
- Commanding Officer, INHS Kalyani, Visakhapatnam
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Araújo MG, Gonçalves DU, Carneiro-Proietti ABF, Proietti FA, Guedes ACM. Manifestações cutâneas da infecção e das doenças relacionadas ao vírus linfotrópico de células T humanas do tipo 1. An Bras Dermatol 2008. [DOI: 10.1590/s0365-05962008000500002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O vírus linfotrópico de células T humanas tipo 1 (HTLV-1) é um retrovírus encontrado em todo o mundo e, no Brasil, tem distribuição heterogênea com várias regiões consideradas de alta prevalência. Está relacionado com doenças graves e/ou incapacitantes, como a leucemia/linfoma de células T do adulto, com a doença neurológica conhecida como mielopatia associada ao HTLV-1/paraparesia espástica tropical, com a uveíte associada ao HTLV-1 e com a dermatite infecciosa. O risco para o aparecimento dessas doenças depende, principalmente, de fatores genéticos, da forma como a infecção foi adquirida e da carga proviral. Estima-se que até 10% dos infectados possam desenvolver alguma doença relacionada ao vírus ao longo da vida. O comprometimento da pele tem sido descrito tanto nas doenças relacionadas ao HTLV-1 quanto nos indivíduos portadores assintomáticos. Vários mecanismos são propostos para explicar as lesões da pele, seja pela presença direta do vírus em células, pela imunossupressão ou por resposta inflamatória que a infecção pelo vírus poderia desencadear. Dentre as manifestações dermatológicas mais freqüentes destacam-se a xerose, as dermatofitoses e as infecções bacterianas recorrentes. Neste artigo são revistos os principais aspectos referentes à infecção e às doenças relacionadas ao HTLV- 1, com ênfase na discussão das manifestações dermatológicas observadas nesse contexto.
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Nobre V, Guedes ACM, Proietti FA, Stanciolli E, Martins ML, Serufo JC, Antunes CM, Grossi MA, Lambertucci JR. [Dermatologic lesions in patients infected with the human T-cell lymphotropic virus type 1 (HTLV-1)]. Rev Soc Bras Med Trop 2005; 38:43-52. [PMID: 15717094 DOI: 10.1590/s0037-86822005000100009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Human T-cell Lymphotropic virus type I (HTLV-1) was the first human retrovirus described. Some time after its discovery a group of diseases were related to this virus, such as, adult T-cell leukemia lymphoma (ATLL), HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and HTLV-1 associated uveitis (HAU). In the nineties, HTLV-1 was associated to a severe eczema of children, called infective dermatitis (ID). Since then, several other skin manifestations have been observed in HTLV-1-infected individuals, particularly in patients with ATLL or HAM/TSP. However, according to some reports, dermatologic lesions are also common in asymptomatic HTLV-1 carriers. Besides ID, all other skin lesions reported are nonspecific. The aim of this review is to outline the dermatologic manifestations reported in HTLV-1 infected patients, emphasizing the clinical and epidemiological value of these findings.
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Affiliation(s)
- Vandack Nobre
- Serviço de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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