Pellagra-like skin lesions associated with Wernicke's encephalopathy in a heavy wine drinker.

Abstract

2. Powell FC, Collins S. Pyoderma gangrenosum. Clin had not occurred in any of these patients. Bacterial and Dermatol 2000; 18: 283–293. viral infections are well-known trigger factors for psori3. Paller AS, Sohn EE, Garen PD, Dobson RL, Chadwick asis (7). HIV infection is associated with psoriasis, with EG. Pyoderma gangrenosum in pediatric acquired an overall prevalence of 5–6% (8). This association immunodeŽ ciency syndrome. J Pediatr 1990; 117: 63–69. 4. Clark HH, Cohen PR. Pyoderma gangrenosum in an appears paradoxical, because psoriatic in ammation is HIV-infected patient. J Am Acad Dermatol 1995; 32: mediated by activated T cells and neutrophil chemotaxis. 912–914. In psoriatic lesions, epidermotropism and disease5. Graham JA, Hansen KK, Rabinowitz LG, Esterly NB. associated changes in the T-cell receptor repertoire have Pyoderma gangrenosum in infants and children. Pediatr been detected in CD8 lymphocytes (9). The activation Dermatol 1994; 11: 10–17. 6. Limova, MT. Treatment of pyoderma gangrenosum with and proliferation of CD8 lymphocytes may therefore cultured keratinocyte autografts. J Dermatol Surg Oncol facilitate the development of psoriasis in HIV-infected 1994; 20: 833–836. individuals. This hypothesis is supported by the observa7. Christophers E. The immunopathology of psoriasis. Int tion of improvement of psoriasis in patients after Arch Allergy Immunol 1996; 110: 199–206. initiating HAART (10, 11). 8. Badger J, Berger TG, Gambia C, Koo JY. HIV and psoriasis. Clin Rev Allergy Immunol 1996; 14: 417–431. In our patient, pyoderma gangrenosum and psoriasis 9. Chang JC, Smith LR, Froning KJ, et al. CD8+ T cells in rapidly improved within 6 weeks after initiating psoriatic lesions preferentially use T-cell receptor Vb 3 HAART. Cutaneous dendritic cells play a central role and/or Vb 13.1 genes. Proc Natl Acad Sci USA 1994; 91: in the control of cutaneous immune reactions. 9282–9286. Langerhans’ cells express CD4 molecules, HIV 10. Fischer T, Schworer H, Vente C, Reich K, Ramadori G. Clinical improvement of HIV-associated psoriasis parallels co-receptors and various cytokines (12, 13). Taking this a reduction of HIV viral load induced by eVective antireinto consideration, one might speculate that the troviral therapy. AIDS 1999; 13: 628–629. improvement of both skin diseases was caused 11. Duvic M, Crane MM, Conant M, Mahoney SE, Reveille by restitution of (cutaneous) immune system under JD, Lehrmann SN. Zidovudine improves psoriasis in HAART. human immunodeŽ ciency virus-positive males. Arch Dermatol 1994; 130: 447–451. 12. Lappin MB, Kimber I, Norval M. The role of dendritic cells in cutaneous immunity. Arch Dermatol Res 1996; REFERENCES 288: 109–121. 1. Hickman JG, Lazarus GS. Pyoderma gangrenosum: a 13. Dezutter-Dambuyant C, Charbonnier AS, Schmitt D. reappraisal of associated systemic diseases. Br J Dermatol Epithelial dendritic cells and HIV-1 infection in vivo and in vitro. Pathol Biol 1995; 43: 882–883. 1980; 102: 498–502.