Case Report: Relevance of an Accurate Diagnosis and Monitoring of Infective Dermatitis Associated With Human T-Lymphotropic Virus Type 1 in Childhood.

Paula Benencio,Carolina Berini,Lourdes Arruvito,María Beraza,Laura Praino,Magdalena Lamberti,Nicolás Ducasa,Mirna Biglione,Inés Irurzun

doi:10.3389/fmed.2021.758352

Abstract

Human T-lymphotropic virus type 1 (HTLV-1) is a neglected retrovirus distributed worldwide and the ethiological agent of several pathologies, such as adult T-cell leukemia/lymphoma (ATLL), a chronic myelopathy known as HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH). HTLV-1 presents tropism for CD4+ T cells and induces deregulation of the cytokine profile. IDH is a severe, chronic superinfected eczema generally associated with Staphylococcus aureus and/or Streptococcus beta haemolyticus infection that responds partially to antibiotic therapy but prompt recurrence develops upon treatment withdrawal. IDH could be a risk factor for progression toward both HAM/TSP and ATLL and, similarly to other diseases associated with HTLV-1, it is sub-diagnosed particularly in non-endemic areas. Here, we present a case of IDH in a young boy living in Buenos Aires with symptoms since 2010, at the age of 5. HTLV-1 infection was suspected and confirmed in 2016. The patient exhibited chronic dermatosis with exudative eruption involving mainly the scalp, retroauricular regions, neck and abdomen. Clinical evaluations, routine laboratory tests, full blood count, and HTLV-1 diagnosis for this case are included.

Highlights

Human T-lymphotropic virus type 1 (HTLV-1) is a neglected retrovirus distributed worldwide in endemic regions such as Japan, Rumania, Iran, Jamaica, Western Africa and South America, and mostly diagnosed elsewhere in immigrants from endemic areas
We present the first pediatric case of infective dermatitis associated with HTLV-1 in Argentina
A large number of articles on epidemiology and immuno-virology associated with adult T-cell leukemia/lymphoma (ATLL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) have been published in the scientific literature; there are few reports about infective dermatitis associated with HTLV-1 (IDH)

Summary

INTRODUCTION

Human T-lymphotropic virus type 1 (HTLV-1) is a neglected retrovirus distributed worldwide in endemic regions such as Japan, Rumania, Iran, Jamaica, Western Africa and South America, and mostly diagnosed elsewhere in immigrants from endemic areas. PVL was determined to be 11.5 copies/100 peripheral blood mononuclear cells (PBMC) by quantitative PCR (qPCR) (SybrGreen, ThermoFisher, MA, USA) His mother was found positive for HTLV-1, but none of his siblings. The patient continued to present lower intensity exudative and crusty eczema in folds, scalp, and retroauricular regions; generalized papular eruption involving the face and trunk. The patient still suffered from relapsing chronic dermatitis, presenting recurrences when discontinuing or lowering the antibiotics dose, especially in hot and humid weather. The severity of outbreaks is lower (with scattered skin lesions, mild eczema and papules) and the patient leads a normal social life. He started practicing physical activities and playing soccer.

DISCUSSION

ETHICS STATEMENT

Findings

DATA AVAILABILITY STATEMENT