Mucocutaneous presence of cytomegalovirus associated with human immunodeficiency virus infection: discussion regarding its pathogenetic role.
OBJECTIVE
To investigate the significance of cytomegalovirus (CMV) in mucocutaneous lesions in patients with human immunodeficiency virus (HIV), and to elucidate its pathogenetic role in lesions genesis.


METHODS
Retrospective (study 1) and prospective (studies 2 and 3) surveys.


METHODS
Departments of Dermatology, Pathology, and Microbiology at a university hospital in Madrid, Spain.


METHODS
Seventeen HIV-infected patients with CMV presenting any type of mucocutaneous lesions (study 1); 27 HIV-positive patients with mucocutaneous vesicles and/or ulcers of any type and location (study 2); and 12 severely immunosuppressed HIV-positive volunteers (study 3).


METHODS
Mucocutaneous biopsy specimens from the lesions (studies 1 and 2) and from nonlesional skin (study 3) were analyzed by light microscopy, immunohistochemical analysis, and microbiological analysis (standard viral culture and shell-vial technique).


METHODS
Clinical data; histologic, immunohistochemical, and microbiological findings.


RESULTS
(1) Studies 1 and 2: Most of the lesions where CMV was found were ulcers localized mainly on perianal, genital, and perigenital areas, usually as part of polymicrobial infections, particularly herpes simplex and varicella-zoster virus infections. The finding of CMV was confirmed in all cases by light microscopy; microbiological analysis was rarely useful. The finding of mucocutaneous CMV inclusions allowed their early detection in extracutaneous locations. (2) Study 3: Cytomegalovirus was present on healthy skin of the perianal area in 3 patients, and on the forearm in 1 patient.


CONCLUSIONS
Cytomegalovirus does not play any significant pathogenetic role at least in most of the cutaneous lesions where it is found.
Daudén
E
E
Department of Dermatology, Hospital de la Princesa, Autonoma University of Madrid, c/Diego de León, 62, 28006 Madrid, Spain. edaudent@medynet.com
Fernández-Buezo
G
G
Fraga
J
J
Cardeñoso
L
L
García-Díez
A
A
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001706:Biopsy; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification* / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D019226:Oral Ulcer / Q000821:virology; D011446:Prospective Studies; D012189:Retrospective Studies; D012867:Skin / Q000821:virology*; D012874:Skin Diseases, Infectious / Q000175:diagnosis* / Q000821:virology; D012883:Skin Ulcer / Q000821:virology
D000914:Antibodies, Viral