Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient
Epidermodysplasia verruciformis (EV) is triggered by a variety of mechanisms that at least partly include genetic background. We present a Brazilian man with a 30-year history of flat, wart-like lesions with clinical, histopathological, and evolutive aspects consistent with papillomavirus (HPV)-ass...
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The Journal of Infection in Developing Countries
2011-12-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/2269 |
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| author | Luiz Euribel Prestes-Carneiro Gisele Alborghetti Nai Márcia G. Silva Carlos Cristofano Luciana Leite Crivelin Carmela Beatriz Ramos Calabreta Ricardo Alberto Moliterno Marilda Aparecida Milanez Morgado de Abreu |
| author_facet | Luiz Euribel Prestes-Carneiro Gisele Alborghetti Nai Márcia G. Silva Carlos Cristofano Luciana Leite Crivelin Carmela Beatriz Ramos Calabreta Ricardo Alberto Moliterno Marilda Aparecida Milanez Morgado de Abreu |
| author_sort | Luiz Euribel Prestes-Carneiro |
| collection | DOAJ |
| description |
Epidermodysplasia verruciformis (EV) is triggered by a variety of mechanisms that at least partly include genetic background. We present a Brazilian man with a 30-year history of flat, wart-like lesions with clinical, histopathological, and evolutive aspects consistent with papillomavirus (HPV)-associated EV. Histological analysis of the wart lesions showed epidermis with hyperkeratosis, regular acanthosis, hypergranulosis, and cells with abundant basophilic cytoplasm. Moreover, a perivascular lymphocytic infiltrate was found in the superficial dermis, consistent with a viral wart. Type-2-HPV DNA was detected in various fragments of skin-wart lesions using the polymerase chain reaction (PCR). Two years after the EV diagnosis, the patient presented with an anesthetic well-demarcated, erythematous and mildly scaly plaque on his right forearm. A histopathological analysis of this lesion demonstrated the presence of a compact tuberculoid granuloma. Ziehl-Neelsen staining demonstrated the presence of rare acid-fast bacilli and confirmed the tuberculoid leprosy diagnosis. The patient's Mitsuda Intradermal Reaction was positive. To elucidate the possible mechanism involved in this case of EV, we genotyped the HLA genes of this patient. DQB genotyping showed the polymorphic HLA alleles DQB1*0301 and 0501. The patient was treated with a paucibacillary multi-drug therapy scheme, and the disease was cured in six months. This report describes an EV patient with an M. leprae infection, confirming that tuberculoid leprosy patients possess a relatively specific and efficient cell-mediated immunity against the bacillus and, therefore, localized forms of the disease. Moreover, we show the possible involvement of the polymorphic HLA alleles DQB1*0301 and 0501 in EV induction mechanisms.
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| format | Article |
| id | doaj-art-d0eb4e68406545f99deeee4a64dec579 |
| institution | DOAJ |
| issn | 1972-2680 |
| language | English |
| publishDate | 2011-12-01 |
| publisher | The Journal of Infection in Developing Countries |
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| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-d0eb4e68406545f99deeee4a64dec5792025-08-20T02:57:21ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802011-12-0160610.3855/jidc.2269Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patientLuiz Euribel Prestes-Carneiro0Gisele Alborghetti Nai1Márcia G. Silva2Carlos Cristofano3Luciana Leite Crivelin4Carmela Beatriz Ramos Calabreta5Ricardo Alberto Moliterno6Marilda Aparecida Milanez Morgado de Abreu7Universidade do Oeste Paulista, Presidente Prudente, São Paulo, BrazilUniversidade do Oeste Paulista, Presidente Prudente, São Paulo, BrazilFaculdade de Medicina da UNESP, Botucatu, BrazilUniversidade do Oeste Paulista, Presidente Prudente, São Paulo, BrazilUniversidade do Oeste Paulista, Presidente Prudente, São Paulo, BrazilInstituto Adolfo Lutz, Presidente Prudente, BrazilUniversidade Estadual de Maringá, Maringá, BrazilUniversidade do Oeste Paulista, Presidente Prudente, São Paulo, Brazil Epidermodysplasia verruciformis (EV) is triggered by a variety of mechanisms that at least partly include genetic background. We present a Brazilian man with a 30-year history of flat, wart-like lesions with clinical, histopathological, and evolutive aspects consistent with papillomavirus (HPV)-associated EV. Histological analysis of the wart lesions showed epidermis with hyperkeratosis, regular acanthosis, hypergranulosis, and cells with abundant basophilic cytoplasm. Moreover, a perivascular lymphocytic infiltrate was found in the superficial dermis, consistent with a viral wart. Type-2-HPV DNA was detected in various fragments of skin-wart lesions using the polymerase chain reaction (PCR). Two years after the EV diagnosis, the patient presented with an anesthetic well-demarcated, erythematous and mildly scaly plaque on his right forearm. A histopathological analysis of this lesion demonstrated the presence of a compact tuberculoid granuloma. Ziehl-Neelsen staining demonstrated the presence of rare acid-fast bacilli and confirmed the tuberculoid leprosy diagnosis. The patient's Mitsuda Intradermal Reaction was positive. To elucidate the possible mechanism involved in this case of EV, we genotyped the HLA genes of this patient. DQB genotyping showed the polymorphic HLA alleles DQB1*0301 and 0501. The patient was treated with a paucibacillary multi-drug therapy scheme, and the disease was cured in six months. This report describes an EV patient with an M. leprae infection, confirming that tuberculoid leprosy patients possess a relatively specific and efficient cell-mediated immunity against the bacillus and, therefore, localized forms of the disease. Moreover, we show the possible involvement of the polymorphic HLA alleles DQB1*0301 and 0501 in EV induction mechanisms. https://jidc.org/index.php/journal/article/view/2269Epidermodysplasia verruciformispapillomavirusMycobacterium lepraeDQB1*0301/ 0501HLA alleles |
| spellingShingle | Luiz Euribel Prestes-Carneiro Gisele Alborghetti Nai Márcia G. Silva Carlos Cristofano Luciana Leite Crivelin Carmela Beatriz Ramos Calabreta Ricardo Alberto Moliterno Marilda Aparecida Milanez Morgado de Abreu Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient Journal of Infection in Developing Countries Epidermodysplasia verruciformis papillomavirus Mycobacterium leprae DQB1*0301/ 0501HLA alleles |
| title | Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient |
| title_full | Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient |
| title_fullStr | Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient |
| title_full_unstemmed | Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient |
| title_short | Clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient |
| title_sort | clinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient |
| topic | Epidermodysplasia verruciformis papillomavirus Mycobacterium leprae DQB1*0301/ 0501HLA alleles |
| url | https://jidc.org/index.php/journal/article/view/2269 |
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