title: Herpes simplex virus type-I and pyogenic granuloma: a vascular endothelial growth factor-mediated association?
abstract: Pyogenic granuloma (PG) is a vascular endothelial growth factor (VEGF)-related neoangiogenic process. Minor trauma, chronic irritation, certain drugs and pregnancy may favor PG. Viral triggers have not been reported up to date. A 52-year-old woman with hairy-cell leukemia presented because of a 3-month history of a giant pseudotumoral lesion on her left cheek. All prior antibacterial, antifungal and anti-inflammatory treatments had failed. Histology revealed PG with sparse and isolated epithelial cell aggregates. Immunohistochemistry (IHC) identified herpes simplex virus type-I (HSV-I) antigens in the nuclei and cytoplasm of normal-appearing as well as cytopathic epithelial cells, suggesting a chronic, low-productive HSV infection. No HSV-I signal was evidenced in the endothelial cells of the PG. Furthermore, IHC revealed VEGF in the HSV-I infected epithelial cells as well as within the PG endothelial cells. These results incited oral treatment with valaciclovir, and the PG promptly resolved after 2 weeks. These findings suggest that a chronic HSV-I infection might play an indirect, partial role in neoangiogenesis, presumably via HSV-I infection-related stimulation of keratinocytic VEGF production.
authors.affiliation: Department of Dermatology, CHU of Sart Tilman, University of Liège, Liège, Brussels, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: El Hayderi
authors.forename: D
authors.initials: D
authors.lastname: Paurobally
authors.forename: M F
authors.initials: MF
authors.lastname: Fassotte
authors.forename: J
authors.initials: J
authors.lastname: André
authors.forename: J E
authors.initials: JE
authors.lastname: Arrese
authors.forename: C
authors.initials: C
authors.lastname: Sadzot-Delvaux
authors.forename: A
authors.initials: A
authors.lastname: Ruebben
authors.forename: A F
authors.initials: AF
authors.lastname: Nikkels
keywords: Angiogenesis; Herpes simplex virus; Pyogenic granuloma; Valaciclovir; Vascular endothelial growth factor
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