1
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Razak AA, Shanmugasundaram S. Kikuchi-Fujimoto disease, a rare benign disease with atypical histomorphology: more than meets the eye. Pathology 2024; 56:382-390. [PMID: 38296677 DOI: 10.1016/j.pathol.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 02/02/2024]
Abstract
Kikuchi-Fujimoto disease (KFD) is a benign self-limiting condition primarily affecting young females. It usually presents with fever and cervical lymphadenopathy of unknown aetiology with a preponderance of the Asian population. Histopathology is critical in making an accurate diagnosis. While the typical microscopic features include paracortical necrosis with debris, histiocytosis with immunoblasts, and absent neutrophils, rarely, KFD can show atypical features like marked immunoblastic proliferation mimicking lymphoma, demonstrate vasculitis mimicking lupus erythematosus, etc. The diagnosis is extremely challenging if such features occur in cases with generalised lymphadenopathy, which is infrequent in KFD. The study aims to describe the morphological, clinical, and immunohistochemical features of KFD and determine the frequency of the atypical features. We also analysed the subtle histological and immunohistochemical features that aid in the diagnosis of atypical cases. Cases reported as KFD over a period of 6 years were retrieved from the archives of histopathology. The morphological features were categorised as typical and atypical. In the atypical cases, the features that aided in the correct diagnosis of KFD were analysed. Out of the 42 cases evaluated, 23.9% (n=10) had generalised lymphadenopathy; 57.2% (n=24) were women with a median age of 25 years. Leukopenia was observed in 42% (n=13) of patients. Typical features were present in 76.2% (n=32) cases and 23.8% (n=10) presented with atypical features. Eight cases were antinuclear antibody-positive. Atypical features included five (50%) cases with vasculitis and panniculitis, and three (30%) cases with large, atypical cells for which immunohistochemistry (IHC) was performed. In two of these cases, the patent sinuses, absence of neutrophils, and IHC with CD68 aided the diagnosis. There is an overlap of clinical and histopathological features between KFD and malignant lymphomas and systemic lupus erythematosus. Given the fact that the atypical features (23.8%) are not rare occurrences in KFD, correlations with clinical findings and ancillary studies are essential to avoid misdiagnosis and inadvertent therapy.
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Affiliation(s)
- Ahlam Abdul Razak
- Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, India
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2
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Saberi SA, Kumar AM, Davis D, Nambudiri VE. Florid cutaneous morbilliform eruption in the setting of primary Epstein-Barr virus infection. JAAD Case Rep 2024; 45:102-105. [PMID: 38434596 PMCID: PMC10907508 DOI: 10.1016/j.jdcr.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Affiliation(s)
| | - Anusha M. Kumar
- Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dale Davis
- Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Vinod E. Nambudiri
- Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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3
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Zhang R, Mao Z, Xu C, Wang W, Kwong JSW, Xu M, Song Y, Lv T, Teng Z, Zhong R, Liu H, Liu Y, Wang Q, Wang Y, Zhang Y, Chen S, Chai X, He R, Zheng W, Zhang J. Association between Antibiotic Exposure and the Risk of Rash in Children with Infectious Mononucleosis: a Multicenter, Retrospective Cohort Study. Antimicrob Agents Chemother 2023; 67:e0024923. [PMID: 37219437 PMCID: PMC10269065 DOI: 10.1128/aac.00249-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/13/2023] [Indexed: 05/24/2023] Open
Abstract
Present evidence suggests that the administration of antibiotics, particularly aminopenicillins, may increase the risk of rash in children with infectious mononucleosis (IM). This retrospective, multicenter cohort study of children with IM was conducted to explore the association between antibiotic exposure in IM children and the risk of rash. A robust error generalized linear regression was performed to address the potential cluster effect, as well as confounding factors such as age and sex. A total of 767 children (aged from 0 to 18 years) with IM from 14 hospitals in Guizhou Province were included in the final analysis. The regression analysis implied that exposure to antibiotics was associated with a significantly increased incidence of overall rash in IM children (adjusted odds ratio [AOR], 1.47; 95% confidence interval [CI], ~1.04 to 2.08; P = 0.029). Of 92 overall rash cases, 43 were probably related to antibiotic exposure: two cases (4.08%) in the amoxicillin-treated group and 41 (8.15%) in the group treated with other antibiotics. Regression analysis indicated that the risk of rash induced by amoxicillin in IM children was similar to that induced by other penicillins (AOR, 1.12; 95% CI, ~0.13 to 9.67), cephalosporins (AOR, 2.45; 95% CI, ~0.43 to 14.02), or macrolides (AOR, 0.91; 95% CI, ~0.15 to 5.43). Antibiotic exposure may be associated with an increased risk of overall rash in IM children, but amoxicillin was not found to be associated with any increased risk of rash during IM compared to other antibiotics. We suggest that clinicians be vigilant against the occurrence of rash in IM children receiving antibiotic therapy, rather than indiscriminately avoiding prescribing amoxicillin.
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Affiliation(s)
- Rui Zhang
- Department of Pharmacy, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Zhen Mao
- Department of Pharmacy, Guiyang Maternal and Child Health Care Hospital, Guiyang, China
| | - Chang Xu
- College of Public Health, Anhui Medical University, Hefei, China
| | - Wen Wang
- Chinese Evidence-Based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, China
| | - Joey Sum-wing Kwong
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
| | - Minjie Xu
- Department of Pharmacy, Liupanshui Maternal and Child Health Care Hospital, Liupanshui, China
| | - Yi Song
- Department of Pharmacy, Tongren City People’s Hospital, Tongren, China
| | - Tianyi Lv
- Department of Pharmacy, Xingyi People’s Hospital, Xingyi, China
| | - Zhiyuan Teng
- Department of Pharmacy, Guiyang Second People’s Hospital, Guiyang, China
| | - Ruifeng Zhong
- Department of Pharmacy, Jinsha People’s Hospital, Bijie, China
| | - Hui Liu
- Department of Pharmacy, Anshun People’s Hospital of Guizhou Province, Anshun, China
| | - Yang Liu
- Department of Pharmacy, The Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Qin Wang
- Department of Pharmacy, People’s Hospital of Qianxinan Prefecture, Xingyi, China
| | - Ying Wang
- Department of Pharmacy, GuiHang GuiYang Hospital, Guiyang, China
| | - Yuan Zhang
- Department of Pharmacy, The First People’s Hospital of Bijie, Bijie, China
| | - Shuya Chen
- Department of Pharmacy, The First People’s Hospital of Guiyang, Guiyang, China
| | - Xiuli Chai
- Department of Pharmacy, Qiannan Buyei and Miao Autonomous Prefecture People’s Hospital, Duyun, China
| | - Rui He
- Department of Laboratory Medicine, Experimental Cancer Medicine, Karolinska Institute, Stockholm, Sweden
| | - Wenyi Zheng
- Department of Laboratory Medicine, Experimental Cancer Medicine, Karolinska Institute, Stockholm, Sweden
| | - Jiaxing Zhang
- Department of Pharmacy, Guizhou Provincial People’s Hospital, Guiyang, China
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4
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Papakonstantinou E, Io Diakou K, Mitsis T, Dragoumani K, Bacopoulou F, Megalooikonomou V, Kossida S, Chrousos GP, Vlachakis D. Molecular fusion events in carcinogenic organisms: a bioinformatics study for the detection of fused proteins between viruses, bacteria and eukaryotes. EMBNET.JOURNAL 2022; 27:e1004. [PMID: 35464257 PMCID: PMC9029568 DOI: 10.14806/ej.27.0.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Molecular fusion events have a prominent role in the initial steps of carcinogenesis. In this study, a bioinformatics analysis was performed between four organisms that are known to induce cancer development in humans: two viruses, Human Herpesvirus 4, and Human T-cell leukaemia virus, one bacterium, Helicobacter Pylori, and one trematode, Schistosoma mansoni. The annotated proteomes from these organisms were analysed using the SAFE software to identify protein fusion events, which may provide insight into protein function similarities and possible merging events during the course of evolution. Based on the results, five fused proteins with very similar functions were detected, whereas proteins with different functions that might act in the same molecular complex or biochemical pathway were not found. Thus, this study analysed the above four well-known cancer-related organisms with de novo bioinformatics programs and provided useful information on protein fusion events, hopefully leading to deeper understanding of carcinogenenesis.
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Affiliation(s)
- Eleni Papakonstantinou
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Kalliopi Io Diakou
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Thanasis Mitsis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Konstantina Dragoumani
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Flora Bacopoulou
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Vasilis Megalooikonomou
- Computer Engineering and Informatics Department, School of Engineering, University of Patras, Patras. Greece
| | - Sophia Kossida
- IMGT, The International ImMunoGeneTics Information System, Université de Montpellier, Laboratoire d'ImmunoGénétique Moléculaire and Institut de Génétique Humaine, University of Montpellier, Montpellier, France
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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5
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Érythème noueux et dermatose neutrophilique révélant une primo-infection EBV. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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Tedbirt B, Dubois S, Cellier L, Carvalho P, Stamatoullas A, Courville P, Deschamps‐Huvier A, Etancelin P, Deniel A, Tilly H, Jardin F, Joly P, Camus V. Multiple cutaneous ulcers revealing a primary cutaneous Epstein-Barr virus-positive diffuse large B-cell lymphoma. Clin Case Rep 2020; 8:2578-2582. [PMID: 33363783 PMCID: PMC7752427 DOI: 10.1002/ccr3.3239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/09/2022] Open
Abstract
Primary cutaneous EBV-positive diffuse large B-cell lymphoma is an exceptional and aggressive neoplasia with a poorer prognosis than other cutaneous lymphoma. Our observation points out the rarity of the presentation and the dismal clinical course.
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Affiliation(s)
- Billal Tedbirt
- Department of DermatologyCharles Nicolle University HospitalRouenFrance
| | - Sydney Dubois
- Department of HematologyCentre Henri BecquerelRouenFrance
| | - Lucie Cellier
- Department of PathologyCharles Nicolle University HospitalRouenFrance
| | | | | | | | | | | | - Anne Deniel
- Department of Medical OncologyCentre Henri BecquerelRouenFrance
| | - Hervé Tilly
- Department of HematologyCentre Henri BecquerelRouenFrance
| | - Fabrice Jardin
- Department of HematologyCentre Henri BecquerelRouenFrance
| | - Pascal Joly
- Department of DermatologyCharles Nicolle University HospitalRouenFrance
| | - Vincent Camus
- Department of HematologyCentre Henri BecquerelRouenFrance
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7
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Zare SY. Infectious disorders of the vulva. Semin Diagn Pathol 2020; 38:19-26. [PMID: 33067080 DOI: 10.1053/j.semdp.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 11/11/2022]
Abstract
The vulva can be affected by a variety of sexually transmitted infections as well as other common infections that are not typically related to sexual transmission. Vulvar infections may adversely affect the quality of life of the patients by causing discomfort and pain. Some of these infections, especially the ulcerative ones, may also increase the risk of transmission of other infectious diseases, including HIV. Due to the recently increasing number of sexually transmitted infections and atypical presentations of these infections in immunocompromised patients, it is important for pathologists to be familiar with histopathologic features of the infectious diseases of the vulva, so that accurate diagnoses can be rendered as promptly as possible. This review discusses the clinicopathologic presentations of the non-HPV related infections of the vulva.
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Affiliation(s)
- Somaye Y Zare
- Department of Pathology, University of California San Diego, La Jolla, CA, USA.
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8
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Liu N, Chen Z, Xing D. Integrated photoacoustic and hyperspectral dual-modality microscopy for co-imaging of melanoma and cutaneous squamous cell carcinoma in vivo. JOURNAL OF BIOPHOTONICS 2020; 13:e202000105. [PMID: 32406187 DOI: 10.1002/jbio.202000105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 05/09/2023]
Abstract
Skin carcinoma such as melanoma (MM) and cutaneous squamous cell carcinoma (cSCC) are considered as the highest mortality and the most aggressive skin cancers in dermatology. In view that early diagnosis and treatment can greatly improve the survival rate and life quality of the patients, developing noninvasive and effective evaluation methods is of great significance for the detection and identification of early stage cutaneous cancers. In this article, we propose a hybrid photoacoustic and hyperspectral dual-modality microscopy to evaluate and differentiate skin carcinoma by structural and multiphysiological parameters. The proposed system's imaging abilities are verified by mimic phantoms and normal mice experiments. Furthermore, in vivo characterization and evaluation results of MM and cSCC mice are obtained successfully, which prove this novel method could be used as a reliable and useful method for skin cancer detection in early stages.
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Affiliation(s)
- Ning Liu
- MOE Key Laboratory of Laser Life Science, Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
| | - Zhongjiang Chen
- MOE Key Laboratory of Laser Life Science, Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
| | - Da Xing
- MOE Key Laboratory of Laser Life Science, Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, China
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9
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Sanchez A, Sohier P, Benghanem S, L’Honneur AS, Rozenberg F, Dupin N, Garel B. Digitate Papulosquamous Eruption Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Dermatol 2020; 156:819-820. [DOI: 10.1001/jamadermatol.2020.1704] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Adrien Sanchez
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Division of Dermatology and Venereology, AP-HP Centre-Université de Paris, Paris, France
| | - Pierre Sohier
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Division of Pathology, AP-HP Centre-Université de Paris, Paris, France
| | - Sarah Benghanem
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Division of Intensive Care, AP-HP Centre-Université de Paris, France
| | - Anne-Sophie L’Honneur
- Laboratory of Virology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP Centre-Université de Paris, Paris, France
| | - Flore Rozenberg
- Laboratory of Virology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP Centre-Université de Paris, Paris, France
| | - Nicolas Dupin
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Division of Dermatology and Venereology, AP-HP Centre-Université de Paris, Paris, France
| | - Bethsabée Garel
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Division of Dermatology and Venereology, AP-HP Centre-Université de Paris, Paris, France
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10
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Costa FH, Costa V, León JE, Anbinder AL, Ribeiro-Silva A, Kaminagakura E. Oral hairy leukoplakia in a child using a corticosteroid nasal spray. Pediatr Dermatol 2020; 37:721-723. [PMID: 32372427 DOI: 10.1111/pde.14194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a case of atypical oral hairy leukoplakia (OHL) in a 9-year-old immunocompetent girl treated with fluticasone propionate nasal spray for allergic rhinitis. The OHL in childhood is uncommon and should be included in a differential diagnosis of white lesions in the oral mucosa.
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Affiliation(s)
- Fernanda Herrera Costa
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Victor Costa
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Jorge Esquiche León
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Ana Lia Anbinder
- Department of Stomatology, Collective Health and Legal Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Alfredo Ribeiro-Silva
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Estela Kaminagakura
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
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11
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Ciccarese G, Trave I, Herzum A, Parodi A, Drago F. Dermatological manifestations of Epstein-Barr virus systemic infection: a case report and literature review. Int J Dermatol 2020; 59:1202-1209. [PMID: 32346863 DOI: 10.1111/ijd.14887] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/27/2020] [Accepted: 03/26/2020] [Indexed: 12/27/2022]
Abstract
Epstein-Barr virus (EBV) is a human herpesvirus spread in childhood by contact with saliva. In all populations, the great majority of people are infected by middle age. EBV can cause asymptomatic infection, nonspecific symptoms or, especially in adolescents and young adults, the infectious mononucleosis (IM), characterized by pharyngitis, lymphadenopathy, fatigue, and fever. Two main types of skin rashes, accounted as atypical exanthems, occur in patients with acute IM: a faint erythematous maculopapular eruption of 24-48 hours duration (5-15% of the patients) or a pruritic maculopapular rash in almost all patients receiving ampicillin or amoxicillin. Moreover EBV acute infection has been related to other cutaneous manifestations, such as Gianotti-Crosti syndrome, unilateral laterothoracic exanthem (especially in children), and others. In this study, we reported a case of atypical exanthem with an erythematous-papulovesicular pattern in a 22-year-old female patient with IM and performed a review of the literature of the cutaneous and mucosal eruptions occurring during EBV acute infections.
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Affiliation(s)
- Giulia Ciccarese
- Dermatology Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Ilaria Trave
- DI.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy
| | - Astrid Herzum
- DI.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy
| | - Aurora Parodi
- Dermatology Clinic, Ospedale Policlinico San Martino, Genoa, Italy.,DI.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy
| | - Francesco Drago
- Dermatology Clinic, Ospedale Policlinico San Martino, Genoa, Italy
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12
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Han X, Xu P, Duan X, Liu Y, Zhang J, Xu H. High mean platelet volume-to-platelet count ratio as a diagnostic maker for increased risk of liver function damage in pediatric patients with infectious mononucleosis in China. Exp Ther Med 2019; 18:4523-4527. [PMID: 31777555 DOI: 10.3892/etm.2019.8104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 09/10/2019] [Indexed: 01/22/2023] Open
Abstract
The aim of the present study was to provide novel laboratory indexes for infectious mononucleosis (IM) in pediatric patients. In the present prospective study, a total of 141 pediatric patients with IM and 146 healthy subjects were enrolled. The white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HB), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), uric acid (UA), urea, creatinine, total cholesterol (TC) and triglycerides (TG) in peripheral blood were evaluated. WBC, ALT, AST, GGT, UA, TG, MPV and the MPV/PLT ratio in the patients were significantly higher compared with those in the controls (P<0.01), while RBC, HB, urea, TC, PLT and PDW were significantly lower in the patients (P<0.05 for PDW and P<0.01 for others). Regression analysis under stepwise adjustment indicated that PLT and MPV/PLT were significantly associated with IM (P<0.01). Furthermore, MPV/PLT was positively correlated with ALT, AST, GGT, UA and TC (P≤0.01). In the receiver operating characteristic analysis, a sensitivity of 83.7% and specificity of 76.0% regarding the prediction of IM in pediatric patients using the MPV/PLT ratio was achieved at the cutoff of MPV/PLT(%)=3.42. In conclusion, the MPV/PLT ratio may be a novel diagnostic indicator for pediatric IM and indirectly predict damage to liver function.
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Affiliation(s)
- Xiucui Han
- Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310051, P.R. China
| | - Pengfei Xu
- Clinical Laboratory, Zhejiang Hospital, Hangzhou, Zhejiang 310013, P.R. China
| | - Xiuzhi Duan
- Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Yongxia Liu
- Clinical Laboratory, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Junfeng Zhang
- Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310051, P.R. China
| | - Hui Xu
- Zhejiang Key Laboratory for Neonatal Diseases, Clinical Laboratory, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310051, P.R. China
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13
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Ahn SS, Lee B, Kim D, Jung SM, Lee SW, Park MC, Park YB, Hwang YG, Song JJ. Evaluation of macrophage activation syndrome in hospitalised patients with Kikuchi-Fujimoto disease based on the 2016 EULAR/ACR/PRINTO classification criteria. PLoS One 2019; 14:e0219970. [PMID: 31318961 PMCID: PMC6638985 DOI: 10.1371/journal.pone.0219970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/06/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To evaluate the impact of macrophage activation syndrome (MAS) on clinical features in patients with Kikuchi-Fujimoto disease (KFD) and to compare the features of MAS in KFD with those of adult-onset Still's disease (AOSD) and systemic lupus erythematosus (SLE). METHODS The medical records of febrile patients hospitalised with KFD between November 2005 and April 2017 were reviewed. Patients fulfilling the 2016 classification criteria for MAS were classified as having MAS. Clinical and laboratory features of patients with KFD with and without MAS were evaluated. Poor hospitalisation outcomes were defined as intensive care unit admission or in-hospital mortality. The treatment outcomes of MAS in KFD, AOSD, and SLE were also compared. RESULTS Among 78 patients hospitalised with KFD, 24 (30.8%) patients had MAS during admission. Patients with KFD and MAS more frequently required glucocorticoid treatment (66.7% vs 40.7%, p = 0.036) and had longer hospital stays than patients with KFD without MAS (12.5 vs 8.5 days, p<0.001). In addition, patients with MAS had worse hospitalisation outcomes than patients without MAS (29.2% vs. 0.0%, p<0.001). Among patients with MAS in KFD, AOSD, and SLE, the number of patients requiring glucocorticoid treatment after 3 months was significantly lower among patients with MAS and KFD (KFD 33.3%, AOSD 88.9%, SLE 100%, p<0.001). CONCLUSIONS The presence of MAS in KFD was associated with adverse clinical outcomes including higher steroid usage and worse hospitalisation outcomes. However, compared to those with AOSD and SLE, patients with MAS and KFD were less likely to require long-term glucocorticoid treatment.
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Affiliation(s)
- Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Byeori Lee
- Department of Internal Medicine, Albert Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Dam Kim
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Min Jung
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Min-Chan Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Gil Hwang
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jason Jungsik Song
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
- * E-mail:
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14
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Adler BL, DeLeo VA. Actinic Prurigo and Hydroa Vacciniforme. CURRENT DERMATOLOGY REPORTS 2019. [DOI: 10.1007/s13671-019-0255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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15
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Sangueza-Acosta M, Sandoval-Romero E. Epstein-Barr virus and skin. An Bras Dermatol 2019; 93:786-799. [PMID: 30484521 PMCID: PMC6256212 DOI: 10.1590/abd1806-4841.20187021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 03/12/2018] [Indexed: 11/22/2022] Open
Abstract
Epstein-Barr virus is a DNA virus infecting human beings and could affect 90% of human population. It is crucial to take in account that in Latin America, unlike what happens in developed countries, the exposure to the virus is very early and therefore people have a much longer interaction with the virus. The virus is related to many diseases, mainly the oncological ones, and when the onset is in cutaneous tissue, it can present many clinical variants, as well acute as chronic ones. Among the acute ones are infectious mononucleosis rash and Lipschutz ulcers; the chronic presentations are hypersensivity to mosquito bites, hydroa vacciniforme, hydroa vacciniforme-like lymphoma, its atypical variants and finally nasal and extra-nasal NK/T-cell lymphoma. Although they are not frequent conditions, it is crucial for the dermatologist to know them in order to achieve a correct diagnosis.
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16
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Knöpfel N, Noguera-Morel L, Latour I, Torrelo A. Viral exanthems in children: A great imitator. Clin Dermatol 2019; 37:213-226. [PMID: 31178104 DOI: 10.1016/j.clindermatol.2019.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Viral exanthems are frequent in children and are mostly self-limited. Early recognition and differentiation from other childhood illnesses are important to direct further investigations and treatment initiation. The clinical presentation of viral exanthems in children includes a polymorphic spectrum of skin eruptions ranging from classic viral exanthems to "atypical" presentations that can mimic nonviral diseases; thus, viral exanthems of childhood can be readily diagnosed on clinical grounds, but not rarely do they represent a diagnostic challenge. In this review, we focus on viral diseases in children that may be difficult to diagnose due to their clinical similarities with nonviral diseases, and we offer clues for the differential diagnosis and proper diagnostic testing in such cases.
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Affiliation(s)
- Nicole Knöpfel
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland; Department of Dermatology, University Children's Hospital Niño Jesús, Madrid, Spain
| | - Lucero Noguera-Morel
- Department of Dermatology, University Children's Hospital Niño Jesús, Madrid, Spain
| | - Irene Latour
- Department of Dermatology, University Children's Hospital Niño Jesús, Madrid, Spain
| | - Antonio Torrelo
- Department of Dermatology, University Children's Hospital Niño Jesús, Madrid, Spain.
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17
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Naqvi AR, Shango J, Seal A, Shukla D, Nares S. Herpesviruses and MicroRNAs: New Pathogenesis Factors in Oral Infection and Disease? Front Immunol 2018; 9:2099. [PMID: 30319604 PMCID: PMC6170608 DOI: 10.3389/fimmu.2018.02099] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 08/24/2018] [Indexed: 12/28/2022] Open
Abstract
The oral cavity incessantly encounters a plethora of microorganisms. Effective and efficient oral innate and adaptive immune responses are incumbent to maintain healthy mucosa. A higher prevalence of Human Herpesviruses (HHV), a family of large enveloped DNA viruses, has been reported in multiple oral inflammatory diseases suggesting their involvement in disease progression. However, the viral components contributing to oral disease remain obscure. MicroRNAs (miRNA) are non-protein coding, single stranded ribonucleic acid (RNA) molecules that post-transcriptionally regulate diverse messenger RNAs. Thus, miRNAs can control large repertoire of biological processes. Changes in miRNA expression are associated with various oral infections and diseases. Cellular miRNAs can act as pro- or anti-viral factors and dysregulation of host miRNA expression occurs during herpesviruses infection. This strongly suggest a critical role of cellular miRNAs in host-herpesvirus interaction. Interestingly, HHV also encode multiple miRNAs (called viral miRNAs) that may play key role in host-pathogen interaction by modulating both host biological pathways and controlling viral life cycle. Recent studies from our laboratory have identified viral miRNAs (v-miRs) in diseased oral tissue biopsies and demonstrate their immunomodulatory roles. This review discusses the association of miRNAs (both host and viral) and herpesviruses in the pathogenesis of oral inflammatory diseases.
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Affiliation(s)
- Afsar R Naqvi
- Mucosal Immunology Lab, College of Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Jennifer Shango
- Mucosal Immunology Lab, College of Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Alexandra Seal
- Mucosal Immunology Lab, College of Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Deepak Shukla
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, United States.,Department of Ophthalmology and Visual Sciences, University of Illinois Medical Center, Chicago, IL, United States
| | - Salvador Nares
- Mucosal Immunology Lab, College of Dentistry, University of Illinois at Chicago, Chicago, IL, United States
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18
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Danielsson K, Nylander E, Sjöström M, Ebrahimi M. Epstein-Barr virus is not detected in mucosal lichen planus. Med Oral Patol Oral Cir Bucal 2018; 23:e560-e563. [PMID: 30148472 PMCID: PMC6167091 DOI: 10.4317/medoral.22617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 12/23/2022] Open
Abstract
Background Lichen planus (LP) is a chronic inflammatory, immunological, mucocutaneous disease can affect skin, genital and oral mucosa. Oral lichen planus (OLP) is the most common noninfectious, chronic inflammatory oral disease affecting 1-2% of the general adult population. World Health Organization (WHO) classifies OLP as a potentially malignant disorder. Epstein Barr virus or human herpesvirus-4, is a member of the herpes virus family and one of the most ubiquitous viruses known to human, infecting approximately 90% of the world’s adult population. The virus often infects B lymphocytes resulting in a wide spectrum of mucocutaneous and systemic diseases, ranging from mild lesions to aggressive malignancies. The aim of this study was to investigate expression of the EBV encoded RNAs EBER1 and EBER2 in oral and genital lichen planus and compare results with normal tissues in situ hybridization which is considered the golden standard for detection of EBER. Material and Methods A total of 68 biopsies, 25 oral LP, 26 genital LP, 10 oral controls and finally 7 genital controls were analysed using situ hybridization. Results All samples had RNA as shown by the control slide, whereas no case contained neither EBER1 nor EBER2. Conclusions Based on results from our study EBV is not involved in aetiology of lichen planus. Key words:Mucosal lichen planus, Epstein - Barr virus.
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Affiliation(s)
- K Danielsson
- Department of Odontology, Umeå University, SE - 901 85 Umeå, Sweden,
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19
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Crighton BK, Thomas C. Primary Ebstein-Barr Virus Infection Presenting with Prominent Lip and Tongue Swelling. J Paediatr Child Health 2018; 54:1052-1053. [PMID: 30178587 DOI: 10.1111/jpc.14137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Bianca K Crighton
- Department of Paediatrics, Sunshine Coast Hospital and Health Service, Nambour, Queensland, Australia
| | - Clare Thomas
- Department of Paediatrics, Sunshine Coast Hospital and Health Service, Nambour, Queensland, Australia
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20
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Shanahan D, Cowie R, Rogers H, Staines K. Oral hairy leukoplakia in healthy immunocompetent patients: a small case series. Oral Maxillofac Surg 2018; 22:335-339. [PMID: 30079439 DOI: 10.1007/s10006-018-0709-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/02/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV) and usually presents in patients with human immunodeficiency virus (HIV) infection and systemic immunosuppression. It is rarely seen in patients who are immunocompetent. It is clinically characterised as an asymptomatic, soft, white and corrugated lesion that cannot be scraped from the surface it adheres to. METHODS Immunocompetent patients with OHL attending Bristol Dental Hospital within the last 6 months were identified. EBV infection was demonstrated using EBV in situ hybridization. Clinical features and medical history were determined by reviewing medical records. CASE REPORT Four cases of OHL in immunocompetent individuals were identified. All lesions were located on the lateral borders of the tongue. DISCUSSION OHL should be considered as a differential diagnosis for white patches on the lateral borders of the tongue in apparently healthy immunocompetent patients, even when they do not have a typical corrugated appearance. OHL should no longer be regarded as pathognomonic for HIV infection or systemic immunosuppression.
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Affiliation(s)
- Daire Shanahan
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England.
| | - Rachel Cowie
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England
| | - Helen Rogers
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England
| | - Konrad Staines
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England
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21
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Aguilera N, Gru AA. Reexamining post-transplant lymphoproliferative disorders: Newly recognized and enigmatic types. Semin Diagn Pathol 2018; 35:236-246. [DOI: 10.1053/j.semdp.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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22
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Oral hairy leukoplakia in the buccal mucosa of a healthy, HIV-negative patient. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.412354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
PURPOSE OF REVIEW The photodermatoses represent a group of disorders of sensitivity to light that continue to pose difficulties in diagnosis and management. Photodermatoses are of interest to allergists because many photosensitive skin disorders have immunologic underpinnings, and patients often present to clinic complaining of "allergy" to the sun. We provide a concise reference for allergists on the clinical recognition and management of photodermatitis. RECENT FINDINGS New developments in the understanding of immunomodulatory effects of light have demonstrated normally immunosuppressive responses in the skin to light exposure, and a blunted immunosuppressive response in the pathogenesis of many photodermatoses. Vitamin D plays an important role in immunomodulation and itself may be affected by photodermatoses due to the impact of photoprotective treatment strategies on circulating vitamin D levels. The elucidation of the immunological basis of many photodermatoses may provide guidance for developing new treatment modalities. Further research is necessary to determine the optimal management of vitamin D metabolism in patients with photodermatoses.
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Affiliation(s)
- Samuel L Coffin
- Division of Dermatology, Augusta University, 1004 Chafee Ave, FH-100, Augusta, GA, 30904, USA
| | - Jake E Turrentine
- Division of Dermatology, Augusta University, 1004 Chafee Ave, FH-100, Augusta, GA, 30904, USA.
| | - Ponciano D Cruz
- Department of Dermatology, The University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, 75390-9069, USA.,North Texas Veterans Affairs Medical Center, Dallas, TX, USA
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24
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Levoska MA, Cohen JI, Manoli I, Richard Lee CC, Ching SST, Shand J, Tamura D, Kraemer KH, DiGiovanna JJ. Recurrent scarring papulovesicular lesions on sun-exposed skin in a 22-year-old man. J Am Acad Dermatol 2017; 78:637-642. [PMID: 28964535 DOI: 10.1016/j.jaad.2017.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 07/28/2017] [Accepted: 08/03/2017] [Indexed: 12/12/2022]
Abstract
KEY TEACHING POINTS.
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Affiliation(s)
- Melissa A Levoska
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Medical Research Scholars Program, National Institutes of Health, Bethesda, Maryland
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Irini Manoli
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Chyi-Chia Richard Lee
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Steven S T Ching
- Flaum Eye Institute, University of Rochester, Rochester, New York
| | - Jessica Shand
- Division of Pediatric Hematology-Oncology and Wilmot Cancer Center, University of Rochester, Rochester, New York
| | - Deborah Tamura
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Kenneth H Kraemer
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - John J DiGiovanna
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
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25
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Kyriakidis I, Vasileiou E, Karastrati S, Tragiannidis A, Gompakis N, Hatzistilianou M. Primary EBV infection and hypersensitivity to mosquito bites: a case report. Virol Sin 2017; 31:517-520. [PMID: 27900557 DOI: 10.1007/s12250-016-3868-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ioannis Kyriakidis
- 2nd Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, 54636, Greece.
| | - Eleni Vasileiou
- 2nd Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, 54636, Greece
| | - Sofia Karastrati
- 2nd Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, 54636, Greece
| | - Athanasios Tragiannidis
- 2nd Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, 54636, Greece
| | - Nikolaos Gompakis
- 2nd Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, 54636, Greece
| | - Maria Hatzistilianou
- 2nd Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, 54636, Greece
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26
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Davis G, Perks A, Liyanage P, Staines K. Oral hairy leukoplakia arising in a patient with hairy cell leukaemia: the first reported case. BMJ Case Rep 2017; 2017:bcr-2016-218663. [PMID: 28385698 DOI: 10.1136/bcr-2016-218663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral hairy leukoplakia (OHL) is an oral mucosal lesion that is associated with Epstein-Barr virus infection. It commonly presents as an asymptomatic, non-removable white patch on the lateral borders of the tongue in individuals who are immunocompromised. Historically, OHL was thought to be pathognomonic of HIV infection; however, it is now an established phenomenon in a range of conditions affecting immune competence. Hairy cell leukaemia (HCL) is a rare chronic B cell lymphoproliferative disease named after the distinctive cytology of the atypical cells. We report the first case of OHL arising in an individual with HCL that resolved following remission of the haematological malignancy.
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Affiliation(s)
- Gemma Davis
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
| | - Alexandra Perks
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
| | - Pemith Liyanage
- Oral and Maxillofacial Pathology, University of Bristol Dental Hospital, Bristol, UK
| | - Konrad Staines
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
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27
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Moretti E, Figura N, Campagna MS, Iacoponi F, Gonnelli S, Collodel G. Infectious Burden and Semen Parameters. Urology 2016; 100:90-96. [PMID: 27793655 DOI: 10.1016/j.urology.2016.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/28/2016] [Accepted: 10/18/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the relationship between chronic infections detected in serum and semen quality. The pathogen burden is a concept consisting in the observation that, in patients with heart disease, damaging effects of the coronary arteries increase concomitantly with the number of agents responsible for chronic infections to which patients mounted a serological response. Previous observations that Helicobacter pylori infection may reduce the semen quality prompted us to perform the present study. METHODS Blood and semen samples were collected from 73 selected men, enrolled from January 2014 to January 2015. Semen characteristics were evaluated by light and transmission electron microscopy. Transmission electron microscopy data were quantified with a mathematical formula providing numerical scores, such as fertility index (FI, number of sperm free from ultrastructural defects) and the percentages of sperm apoptosis, immaturity, and necrosis. Serum samples were examined by enzyme-linked immunosorbent assay for the presence of immunoglobulin G to the most common agents of chronic infections such as H. pylori (HP), Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), and cytomegalovirus (CMV). RESULTS The prevalence of infections was as follows: HP 43.8%, CP 46.6%, MP 72.6%, EBV 95.9%, HSV-1 74.0%, and CMV 46.6%. Concomitantly with the increased number of pathogens against which the patients mounted a significant antibody response, sperm concentration (P <.05), sperm motility (P <.001), and fertility index (P <.001) were significantly reduced and the percentage of necrotic sperm was increased (P <.01). CONCLUSION The higher the number of pathogens stimulating an immunoglobulin G systemic response, the lower was the semen quality.
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Affiliation(s)
- Elena Moretti
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
| | - Natale Figura
- Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Maria Stella Campagna
- Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Francesca Iacoponi
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy
| | - Stefano Gonnelli
- Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Giulia Collodel
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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28
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Chuh A, Zawar V, Lee A, Sciallis G. Is Gianotti-Crosti Syndrome Associated with Atopy? A Case-Control Study and a Postulation on the Intrinsic Host Factors in Gianotti-Crosti Syndrome. Pediatr Dermatol 2016; 33:488-92. [PMID: 27339179 DOI: 10.1111/pde.12886] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate whether Gianotti-Crosti syndrome (GCS) in children is associated with atopy. METHODS The setting was two outpatient clinic. Diagnoses of asthma and atopic dermatitis (AD) were made according to internationally accepted diagnostic criteria. Allergic rhinitis, atopic urticaria, and allergic conjunctivitis were diagnosed clinically. Participants were children with GCS diagnosed over the previous 5 years. For any child with GCS, we extracted the record of the subsequent age and sex pair-matched child seen for problems unrelated to the skin as controls. RESULTS We retrieved the records of 37 pairs of study and control subjects; 28 (76%) children with GCS and 9 (24%) controls had AD (risk ratio [RR] = 3.11[95% confidence interval {CI} 1.73, 5.73]), 31 (84%) children with GCS and 19 (51%) controls had at least one atopic condition (RR = 1.63 [95% CI 1.13, 2.18]) and 11 (30%) children with GCS and 2 (5%) controls had at least three atopic conditions (RR = 5.50 [95% CI 1.29, 35.35]). CONCLUSION GCS is significantly associated with AD and the presence of atopic conditions.
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Affiliation(s)
- Antonio Chuh
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong.
| | | | - Albert Lee
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
| | - Gabriel Sciallis
- Department of Dermatology, College of Medicine, Mayo Clinic, Rochester, Minnesota
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29
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Rahhal H, Nunes JT, Lopes LDC, Prokopowitsch AS. Simultaneous genital ulcer and meningitis: a case of EBV infection. AUTOPSY AND CASE REPORTS 2016; 6:45-9. [PMID: 27547743 PMCID: PMC4982784 DOI: 10.4322/acr.2016.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/14/2016] [Indexed: 12/05/2022] Open
Abstract
The Epstein-Barr virus (EBV) is associated with a broad spectrum of diseases, mainly because of its genomic characteristics, which result in different latency patterns in immune cells and infective mechanisms. The patient described in this report is a previously healthy young man who presented to the emergency department with clinical features consistent with meningitis and genital ulcers, which raised concern that the herpes simplex virus was the causative agent. However, the polymerase chain reaction of cerebral spinal fluid was positive for EBV. The authors highlight the importance of this infection among the differential diagnosis of central nervous system involvement and genital ulceration.
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Affiliation(s)
- Hassan Rahhal
- Internal Medicine Department - Hospital das Clínicas - Universidade de São Paulo - São Paulo/SP - Brazil
| | - Jairo Tavares Nunes
- Internal Medicine Department - Hospital das Clínicas - Universidade de São Paulo - São Paulo/SP - Brazil
| | - Leonardo da Costa Lopes
- Internal Medicine Division - Hospital Universitário - Universidade de São Paulo - São Paulo/SP - Brazil
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30
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Mathew LM, Kapila R, Schwartz RA. Kikuchi-Fujimoto disease: a diagnostic dilemma. Int J Dermatol 2016; 55:1069-75. [PMID: 27207311 DOI: 10.1111/ijd.13314] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/08/2015] [Accepted: 02/03/2016] [Indexed: 11/30/2022]
Abstract
Kikuchi-Fujimoto disease is a benign, self-limiting condition characterized by lymphadenopathy and fever. Its diagnosis can be challenging, as the disease must be differentiated from lymphoma and systemic lupus erythematosus. Patients can present with nonspecific cutaneous lesions. Adequate clinical and histopathologic correlation can aid in the timely diagnosis of Kikuchi's disease, thus preventing the use of unnecessary diagnostic procedures and inappropriate treatments.
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Affiliation(s)
- Laju M Mathew
- Dermatology, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA
| | - Rajendra Kapila
- Infectious Diseases, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA.,Medicine, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA
| | - Robert A Schwartz
- Dermatology, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA. .,Medicine, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA. .,Pathology, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA. .,Pediatrics, Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA. .,Rutgers New Jersey Medical School and Rutgers University School of Public Affairs and Administration, Newark, NJ, USA.
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31
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Bassi A, Venturini E, Montagnani C, de Martino M, Galli L. Gianotti-Crosti Syndrome and Erythema Nodosum: Two Distinct Entities or Two Manifestations of the Same Infection? J Pediatr 2016; 172:217. [PMID: 26896156 DOI: 10.1016/j.jpeds.2016.01.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Andrea Bassi
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Pediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Elisabetta Venturini
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Pediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Carlotta Montagnani
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Pediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Maurizio de Martino
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Pediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Luisa Galli
- Department of Health Sciences, University of Florence, Florence, Italy; Department of Pediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
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33
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Vigarios E, Fricain JC, Projetti F, Boulanger M, Sibaud V. [Oral hairy leukoplakia induced by topical steroids]. Ann Dermatol Venereol 2015; 142:572-6. [PMID: 26362131 DOI: 10.1016/j.annder.2015.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 04/02/2015] [Accepted: 08/05/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral hairy leukoplakia (OHL) is an EBV-associated condition of the oral mucosa, which is often painless. It is found predominantly in HIV-positive patients and is considered a clinical indicator of immunosuppression. OHL has rarely been described in HIV-negative patients, being found most often in association with iatrogenic immunosuppression. OHL induced by topical steroids remains extremely rare. PATIENTS AND METHODS An 81-year-old HIV-negative woman, treated for 3 months with topical steroids for oral lichen planus, developed an asymptomatic white, corrugated, non-removable plaque with vertical folds on the lateral edge of the tongue. Associated oral candidiasis was noted. Based upon histological findings and in situ hybridisation showing numerous EBV-infected epithelial cells, a diagnosis of oral hairy leucoplakia was made. DISCUSSION AND CONCLUSION To our knowledge, we report herein only the second recorded case of OHL induced strictly by topical steroids. Self-medication and poor adherence to dosage recommendations were noted in the patient's medical history. Physicians must be aware of the rare but nevertheless possible adverse events associated with topical steroid use, particularly when such medication is prescribed over a long period for inflammatory diseases of the oral mucosa.
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Affiliation(s)
- E Vigarios
- Médecine bucco-dentaire, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France.
| | - J-C Fricain
- Chirurgie orale, consultation pluridisciplinaire de pathologies de la muqueuse buccale, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France; UFR d'odontologie, 16-20, cours de la Marne, 33082 Bordeaux cedex, France
| | - F Projetti
- Anatomie et cytologie pathologiques, institut universitaire du cancer Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - M Boulanger
- UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France; Chirurgie orale, institut Claudius-Regaud, institut universitaire du cancer Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - V Sibaud
- Dermatologie, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
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