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Andrade de Sousa B, Dos Santos LV, Oliveira TR, Dias AL, Araújo da Costa C, Medeiros Sousa RC, de Sousa MS, Xavier MB. Dermatological manifestations in patients with human T-cell lymphotropic virus at a reference service in Amazon. Int J Dermatol 2019; 58:953-960. [PMID: 30888053 DOI: 10.1111/ijd.14422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 10/01/2018] [Accepted: 02/06/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Individuals infected with the human T-cell lymphotropic virus type 1 (HTLV-1) commonly present skin lesions, which may be a warning sign for the diagnosis of infection. This study describes the most prevalent skin manifestations in HTLV carriers attended at the clinic of Núcleo de Medicina Tropical (NMT) of the Universidade Federal do Pará (UFPA) in Belém, Pará, Brazil. METHODS This is a study of a series of cases of patients infected with human T-cell lymphotropic virus types 1 and 2 (HTLV-1/2) treated at NMT UFPA between 1999 and 2016. A descriptive analysis of data was applied. RESULTS Among 788 surveyed medical records in the service, 15.10% (n = 119) were referred to the dermatology clinic. From the series of cases that presented with skin lesions, 66.39% were female and 33.61% were male, and the average age of this group was 48 years. There was a predominance of patients with noninfectious inflammatory manifestations (64.2%), followed by infectious ones (24.6%), and 1.58% with lymphoproliferative diseases. As for the group of lesions, 45.26% of the erythematous-squamous type were observed, followed by dyschromia (24.21%), and eczematous (14.74%). One patient with a diagnosis of adult T-cell leukemia/lymphoma, another with parapsoriasis, and four with infective dermatitis are highlighted. CONCLUSION Skin disorders in the HLTV positive patient are important causes of referral to the dermatologist with etiological and skin lesions groups diversity. In the series of cases studied, lymphoproliferatives diseases and infective dermatitis associated with HTLV-1 were presented as a challenge for the diagnosis and clinical management of these patients.
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Affiliation(s)
- Brena Andrade de Sousa
- Postgraduate Program in Parasitary Biology in the Amazon, Center of Biological and Health Sciences, State University of Pará and Evandro Chagas Institute, Belém, Pará, Brazil.,Research Laboratory on Skin diseases of Sanitary Interest, Center of Biological and Health Sciences, State University of Pará, Belém, Pará, Brazil
| | - Laisa V Dos Santos
- Medicine course, Center of Biological and Health Sciences, State University of Pará, Belém, Pará, Brazil
| | - Tamires R Oliveira
- Medicine course, Center of Biological and Health Sciences, State University of Pará, Belém, Pará, Brazil
| | - Aline L Dias
- Medicine course, Center of Biological and Health Sciences, State University of Pará, Belém, Pará, Brazil
| | - Carlos Araújo da Costa
- Research Laboratory in Tropical Dermatology and Endemic Diseases, Nucleus of Tropical Medicine, Federal University of Pará, Belém, Pará, Brazil
| | - Rita C Medeiros Sousa
- Research Laboratory in Tropical Dermatology and Endemic Diseases, Nucleus of Tropical Medicine, Federal University of Pará, Belém, Pará, Brazil
| | - Maisa S de Sousa
- Laboratory of Molecular and Cellular Biology, Nucleus of Tropical Medicine, Federal University of Pará, Belém, Pará, Brazil
| | - Marília B Xavier
- Research Laboratory on Skin diseases of Sanitary Interest, Center of Biological and Health Sciences, State University of Pará, Belém, Pará, Brazil.,Research Laboratory in Tropical Dermatology and Endemic Diseases, Nucleus of Tropical Medicine, Federal University of Pará, Belém, Pará, Brazil
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dos Santos HLR, Alves CGB, Almendra Mattos RM, Curi DSC, Leite Ribeiro P, Sarmento VA. Peripheral T-cell non-Hodgkin lymphoma manifesting as a primary lesion on the lip: A rare case report. SPECIAL CARE IN DENTISTRY 2018; 38:438-444. [DOI: 10.1111/scd.12333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/01/2018] [Accepted: 09/07/2018] [Indexed: 02/06/2023]
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Yamashita T, Abbade LPF, Marques MEA, Marques SA. Mycosis fungoides and Sézary syndrome: clinical, histopathological and immunohistochemical review and update. An Bras Dermatol 2012; 87:817-28; quiz 829-30. [PMID: 23197199 PMCID: PMC3699909 DOI: 10.1590/s0365-05962012000600001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 07/19/2011] [Indexed: 12/22/2022] Open
Abstract
This paper reviews the diagnostic and classificatory concepts of mycosis fungoides and Sézary syndrome in light of the latest normative publications. It describes the great variability of the clinical expression of mycosis fungoides in its early stages as well as the histopathological and immunohistochemical aspects that help with diagnosis. The diagnostic criteria required for characterizing Sézary syndrome and the staging system used for both mycosis fungoides and Sézary syndrome are described.
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Affiliation(s)
- Thamy Yamashita
- M.Sc.,PhD in Pathology, Department of Pathology, Botucatu School of
Medicine- Universidade Estadual Paulista "Julio de Mesquita Filho" (São
Paulo State University) (FMB-UNESP) - São Paulo (SP), Brazil
| | - Luciana Patricia Fernandes Abbade
- PhD - Assistant Professor, Department of Dermatology and Radiotherapy,
Botucatu School of Medicine - Universidade Estadual Paulista "Julio de Mesquita
Filho" (São Paulo State University) (FMB-UNESP) - São Paulo (SP),
Brazil
| | - Mariangela Esther Alencar Marques
- Professor, Department of Pathology, Botucatu School of Medicine -
Universidade Estadual Paulista "Julio de Mesquita Filho" (São Paulo
State University) (FMB-UNESP) - São Paulo (SP), Brazil
| | - Silvio Alencar Marques
- Professor - Department of Dermatology and Radiotherapy, Botucatu School
of Medicine - Universidade Estadual Paulista "Julio de Mesquita Filho"
(São Paulo State University) (FMB-UNESP) - São Paulo (SP), Brazil
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Travassos AR, Borges-Costa J, Raposo J, Almeida LS, Filipe P. Recurrence of peripheral T-cell lymphoma as granulomas in the lower limbs. An Bras Dermatol 2012; 87:772-4. [PMID: 23044574 DOI: 10.1590/s0365-05962012000500018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 11/08/2011] [Indexed: 11/22/2022] Open
Abstract
The presence of granulomas in the skin of T-cell lymphoma patients is a rare but well-known phenomenon. The authors present the case of a 44-year-old Caucasian male, with a previously treated peripheral T-cell lymphoma, with cutaneous infiltration and extensive dyschromia on his lower limbs. Skin biopsies revealed the presence of sarcoid granulomas associated with the recurrence of the lymphoma, confirmed by immunostaining and molecular analysis. Although a new scheme of chemotherapy was started, he died 18 months later. There are two different patterns of skin granulomas associated with lymphoma: granulomatous infiltrates admixed with neoplastic cells and cutaneous granulomas constituting a nonspecific manifestation of the underlying lymphoma, but presently there is no evidence supporting their relationship with lymphoma prognosis.
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Affiliation(s)
- Ana Rita Travassos
- Dermatovenereology Department, University Dermatology Clinic, North Lisbon Hospital Center, Santa Maria Hospital, Lisbon, Portugal.
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Ribas J, Schettini APM, Ribas CBDR, Corrêa CDA. Case for diagnosis. Mycosis fungoides. An Bras Dermatol 2011; 85:927-9. [PMID: 21308326 DOI: 10.1590/s0365-05962010000600028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Indexed: 11/22/2022] Open
Abstract
An 18-year old female patient presented with a single, erythematous, desquamative plaque. The clearly outlined lesion was situated in the abdominal region. The patient reported that it had been present for the past year and that she had used no previous medication. Histopathology showed lymphocytic infiltration with atypia, principally affecting the superficial dermis with epidermotropism and mild spongiosis. Immunophenotyping revealed a predominance of CD3-positive cells, confirming the diagnosis of mycosis fungoides.
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Affiliation(s)
- Jonas Ribas
- Department of Dermatology, School of Medicine, Federal University of Amazonas, Manaus, Brazil
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Paschoal RS, Cardilli RN, Arruda D, Simões BP, Souza CDS. [Subcutaneous panniculitis-like T-cell lymphoma]. An Bras Dermatol 2009; 84:415-9. [PMID: 19851676 DOI: 10.1590/s0365-05962009000400015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 10/30/2008] [Indexed: 11/22/2022] Open
Abstract
Subcutaneous panniculitis-like T-cell lymphoma is extremely rare and has recently been recognized as a clinicopathological entity. Young female, 17 years old, has complained of subcutaneous nodules and plaques in the limbs and abdomen for three years, accompanied of mild weight loss without other constitutional symptoms. Nodal, visceral and bone marrow involvement was absent, and subcutaneous CD3/CD8 atypical lymphocyte infiltration was observed in the skin sample. Chemotherapy interrupted the onset of new lesions and led to remission in the 8-month follow-up. Immunophenotypic and molecular aspects were relevant to the diagnosis and as prognosis makers.
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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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