For citation purposes: Bhigjee AI, Hlela C. HTLV-1 infection and disease with special reference to the dermatological manifestations - a critical review. OA Dermatology 2014 Jan 18;2(1):1.

Critical review

 
Laboratory & Clinical Investigations

HTLV-1 infection and disease with special reference to the dermatological manifestations: a critical review

AI Bhigjee, CH Lela
 

Authors affiliations

(1) Department of Neurology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

(2) Division of Dermatology, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

* Corresponding author Email: bhigjee@ukzn.ac.za

Abstract

Introduction

Human T-cell lymphotropic virus type 1 was initially isolated from a patient with cutaneous T-cell lymphoma. Since then, it has been known to be associated with three main disorders, namely adult T-cell leukaemia/lymphoma, human T-cell lymphotropic virus type 1-associated myelopathy and infective dermatitis associated with human T-cell lymphotropic virus type 1. This review examines the dermatological manifestations in detail.

Discussion

Skin manifestations range from xerosis to infective dermatitis associated with human T-cell lymphotropic virus type 1 and lymphoma. The prototype of skin involvement is infective dermatitis associated with human T-cell lymphotropic virus type 1, which occurs in childhood. It is characterised by weeping, erythematous and scaly lesions affecting the face, scalp, retroauricular and flexural areas of the body. Infection with Staphylococcus aureus and haemolytic streptococcus leads to these lesions, which improve only after prolonged antibiotic therapy. Infective dermatitis associated with human T-cell lymphotropic virus type 1 often remits at puberty, but may be a forerunner of human T-cell lymphotropic virus type 1-associated myelopathy or adult T-cell leukaemia/lymphoma. The main differential diagnosis is atopic eczema, an important consideration, as treatment and prognosis are different. A peculiar unexplained feature of infective dermatitis associated with human T-cell lymphotropic virus type 1 is that it occurs in certain ethnic groups, it is common in Caribbean and Sub-Sahara Africa, but almost unheard of in Japanese infected individuals.

Conclusion

Skin involvement occurs in up to 70% of human T-cell lymphotropic virus type 1-infected patients, including otherwise asymptomatic human T-cell lymphotropic virus type 1 carriers. Owing to its varied dermatological manifestations, it is an important consideration in the differential diagnosis in a number of skin disorders occurring in patients living in human T-cell lymphotropic virus type 1-endemic areas.

Licensee OA Publishing London 2014. Creative Commons Attribution License (CC-BY)
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