title: Verrucosis of hands and feet in a patient with combined immune deficiency.
abstract: In immunocompromised patients, warts occur frequently and can be extensive. We describe a 24-year-old patient with severe therapy-resistant warts. In addition to human papillomavirus infection, he had chronic sinusitis, candidiasis, and atopic dermatitis. Anergy to delayed-type hypersensitivity skin test reaction, significant CD4 lymphopenia, and diminished in vitro T-cell proliferative response and interferon-gamma production indicated a deficiency of cellular immunity. Extremely low concentrations of serum IgM and IgG2 and a severe deficiency of in vitro IgM production pointed also to a humoral immunodeficiency syndrome. This case represents a combination of cellular and humoral immunodeficiencies that has not been previously described in association with warts.
authors.affiliation: Department of Dermatology, University Hospital Charité, Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Asadullah
authors.forename: H
authors.initials: H
authors.lastname: Renz
authors.forename: W D
authors.initials: WD
authors.lastname: Döcke
authors.forename: H
authors.initials: H
authors.lastname: Otterbach
authors.forename: U
authors.initials: U
authors.lastname: Wahn
authors.forename: E
authors.initials: E
authors.lastname: Köttgen
authors.forename: H D
authors.initials: HD
authors.lastname: Volk
authors.forename: W
authors.initials: W
authors.lastname: Sterry
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005533:Foot Dermatoses / Q000150:complications*; D006229:Hand Dermatoses / Q000150:complications*; D006801:Humans; D017099:IgG Deficiency / Q000150:complications; D007075:Immunoglobulin M / Q000172:deficiency; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000276:immunology; D008297:Male; D027383:Papillomaviridae; D014412:Tumor Virus Infections / Q000150:complications*; D014860:Warts / Q000150:complications*
chemical_list: D007075:Immunoglobulin M