title: Adult-onset infective dermatitis associated with HTLV-I. Clinical and immunopathological aspects of two cases.
abstract: Infective dermatitis associated with HTLV-I (IDH) is a chronic, infected childhood eczema. Two adult-onset cases of IDH were studied, one of which was associated with HAM/TSP. The patients were submitted to dermatological, neurological and pathological examination. Immunohistochemical studies were made using CD3, CD4, CD8, CD20, CD79a, and CD57 antibodies. Cytotoxic granules were investigated using granzyme B, perforin, and TIA. The patients presented infected erythematous, scaly lesions with mild itching and a good response to sulfamethoxazole/ trimethoprim. A differential diagnosis with atopic dermatitis (AD) and seborrheic dermatitis (SD) was made, based on: the distinctive morphology and distribution of the lesions, presence of exudative and infected lesions, and mild pruritus. The inflammatory infiltrate was composed predominantly of CD8+ lymphocytes that did not present cytotoxic granules. We concluded that IDH can begin in adulthood and may be associated with HAM/TSP. The immunohistochemical findings were different from those observed in AD and SD.
authors.affiliation: Department of Pathology, Hospital Universitário Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil. achilea@uol.com.br
authors.forename: Achiléa L
authors.initials: AL
authors.lastname: Bittencourt
authors.forename: Maria de Fátima
authors.initials: Mde F
authors.lastname: Oliveira
authors.forename: Neide
authors.initials: N
authors.lastname: Ferraz
authors.forename: Maria das Graças
authors.initials: Md
authors.lastname: Vieira
authors.forename: André
authors.initials: A
authors.lastname: Muniz
authors.forename: Carlos
authors.initials: C
authors.lastname: Brites
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D001938:Brazil; D005260:Female; D005500:Follow-Up Studies; D015490:HTLV-I Infections / Q000188:drug therapy / Q000473:pathology*; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D012720:Severity of Illness Index; D017193:Skin Diseases, Viral / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination