title: Infective dermatitis associated with human T-cell lymphotropic virus type 1: evaluation of 42 cases observed in Bahia, Brazil.
abstract: BACKGROUND
  Infective dermatitis associated with human T-cell lymphotropic virus type 1 (HTLV-1; IDH) is a chronic recurrent eczema affecting HTLV-1-infected children. The epidemiological and dermatological characteristics of IDH are described, and their principal diagnostic criteria are reevaluated.
  
  
  METHODS
  Forty-two patients were included: 40 patients serologically positive for HTLV-1 and 2 seronegative patients who tested positive in polymerase chain reaction (PCR) assays.
  
  
  RESULTS
  The mean age at onset of the disease was 2.6 ± 2.4 years (range, 2 months-11 years). The mean duration of breast-feeding was 24.2 months. The lesions were erythematous, scaly, and crusted, always affecting the scalp and retroauricular regions. Crusting of the nostrils was observed in 64.3% of the patients. Of the 36 patients followed up, 23 had the active disease. The age at which IDH disappeared in the others was 10-20 years.
  
  
  CONCLUSIONS
  The onset of IDH may occur earlier than reported in the literature. The scalp and retroauricular regions are always affected, and lesions are invariably present in ≥3 areas. Crusting of the nostrils cannot be considered an obligatory factor for the diagnosis of IDH. The recurring nature of IDH was a characteristic found in all cases. Patients with classic IDH lesions who are serologically negative should be investigated by PCR. Therefore, the indispensable criteria for diagnosis are (1) presence of erythematous-scaly, exudative, and crusted lesions involving ≥3 areas, including the scalp and retroauricular regions; (2) recurring nature of the lesions; and (3) a finding of HTLV-1 infection by serology or molecular biology.
authors.affiliation: Services of Dermatology, Complexo Hospitalar Universitário Prof Edgard Santos, Federal University of Bahia, Brazil.
authors.forename: Maria de Fátima Santos Paim
authors.initials: Mde F
authors.lastname: de Oliveira
authors.forename: Priscila Lima
authors.initials: PL
authors.lastname: Fatal
authors.forename: Janeusa Rita Leite
authors.initials: JR
authors.lastname: Primo
authors.forename: José Lucas Sena
authors.initials: JL
authors.lastname: da Silva
authors.forename: Everton da Silva
authors.initials: Eda S
authors.lastname: Batista
authors.forename: Lourdes
authors.initials: L
authors.lastname: Farré
authors.forename: Achiléa Lisboa
authors.initials: AL
authors.lastname: Bittencourt
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods; D004485:Eczema / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D005260:Female; D015490:HTLV-I Infections / Q000150:complications* / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D009333:Neck / Q000473:pathology; D009666:Nose / Q000473:pathology; D016133:Polymerase Chain Reaction / Q000379:methods; D012008:Recurrence; D012535:Scalp / Q000473:pathology; D012874:Skin Diseases, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D014773:Virology / Q000379:methods