title: Co-presentation of human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis and adult-onset infective dermatitis associated with HTLV-1 infection.
abstract: BACKGROUND
  Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiologic agent of adult T-cell leukemia/lymphoma (ATLL), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), infective dermatitis associated with HTLV-1 (IDH), and various other clinical conditions. Several of these diseases can occur in association.
  
  
  OBJECTIVE
  Report an association of diseases related to HTLV-1 infection, occurring in an unusual age group.
  
  
  METHODS
  Dermatological and laboratory exams were consecutively performed in HTLV-1-infected individuals from January 2008 to July 2010 in the HTLV Outpatient Clinic at the Institute of Infectious Diseases "Emilio Ribas" in São Paulo, Brazil.
  
  
  RESULTS
  A total of 193 individuals (73 HAM/TSP and 120 asymptomatic carriers) were evaluated, three of which were associated with adult-onset IDH and HAM/TSP. In all three cases, the patients were affected by IDH after the development and progression of HAM/TSP-associated symptoms.
  
  
  CONCLUSIONS
  Small number of cases because of the rarity of these diseases.
  
  
  CONCLUSIONS
  We draw attention to the possibility of co-presentation of adult-onset IDH in patients with a previous diagnosis of HAM/TSP, although IDH is a disease classically described in children. Thus, dermatologists should be aware of these diagnoses in areas endemic for HTLV-1 infection.
authors.affiliation: HTLV Outpatient Clinic, Institute of Infectious Diseases Emilio Ribas, São Paulo, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Okajima
authors.forename: Jorge
authors.initials: J
authors.lastname: Casseb
authors.forename: José A
authors.initials: JA
authors.lastname: Sanches
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D003872:Dermatitis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D015490:HTLV-I Infections / Q000150:complications* / Q000175:diagnosis; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000150:complications* / Q000175:diagnosis