title: Flower cells in patients with infective dermatitis associated with HTLV-1.
abstract: BACKGROUND
  Infective dermatitis associated with HTLV-1 (IDH) is a severe childhood form of eczema that may progress to adult T-cell leukemia/lymphoma (ATL).
  
  
  OBJECTIVE
  In this study, the presence of clinical and laboratory parameters suggestive of ATL was evaluated in a cohort of 30 patients with IDH.
  
  
  METHODS
  Over a period of 33 months, the patients were submitted to three-monthly clinical evaluations, routine laboratory exams, full blood count and blood smears, and to six-monthly blood sampling for HTLV-1 proviral load determination. HTLV-1 proviral load was quantified using real-time TaqMan PCR assay.
  
  
  RESULTS
  Abnormal cells (Ably) were found in the peripheral blood smears of nine patients (30%), flower cells being detected in five of these cases (16.6%). The presence of Ably and flower cells was not associated with a higher proviral load in those patients.
  
  
  CONCLUSIONS
  This is the first report on the presence of flower cells in HTLV-1-infected children and adolescents. Furthermore, these cells have not previously been reported in IDH patients. The cases with flower cells probably represent precursory ATL cases, these patients being at a greater risk of developing ATL.
authors.affiliation: Department of Dermatology, Professor Edgar Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil.
authors.forename: Maria de Fátima Paim
authors.initials: Mde F
authors.lastname: de Oliveira
authors.forename: Maria das Graças
authors.initials: Md
authors.lastname: Vieira
authors.forename: Janeusa
authors.initials: J
authors.lastname: Primo
authors.forename: Isadora C
authors.initials: IC
authors.lastname: Siqueira
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Carvalho
authors.forename: Lourdes
authors.initials: L
authors.lastname: Farré
authors.forename: Priscila Lima
authors.initials: PL
authors.lastname: Fatal
authors.forename: Achiléa L
authors.initials: AL
authors.lastname: Bittencourt
mesh_terms: D000293:Adolescent; D001769:Blood / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003584:Cytological Techniques; D003872:Dermatitis / Q000821:virology*; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis* / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D016133:Polymerase Chain Reaction; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification; D017193:Skin Diseases, Viral / Q000175:diagnosis* / Q000821:virology