Chronic Cutaneous Infection Research Articles

Acyclovir resistance in a patient with chronic mucocutaneous herpes simplex infection

Chronic cutaneous herpes simplex virus infection is described in a 68-year-old man who was immunocompromised because of chronic lymphocytic leukemia. The herpes infection was not amenable to therapy with acyclovir. Clinical isolates of herpes simplex virus were assessed for viral thymidine kinase activity, which was markedly decreased in two isolates. By the method of viral plaque autoradiography, these isolates were determined to be composed primarily of mutant thymidine kinase-negative herpes simplex virus mixed with occasional standard thymidine kinase-positive herpes simplex virus. Viral plaque autoradiography permitted the quantitation of proportions of thymidine kinase-negative and thymidine kinase-positive herpes simplex virus in the mixed virus populations. The chronic cutaneous infection persisted, unlike other reported infections by thymidine kinase-negative herpes simplex virus.

Granuloma and Pseudogranuloma of the Skin due to Microsporum canis

A 25-year-old immunosuppressed woman with systemic lupus erythematosus experienced a chronic cutaneous and subcutaneous infection due to Microsporum canis. The clinical course and response to therapy of this extremely rare form of dermatophytosis are described.

Spondyloarthropathy associated with hidradenitis suppurative and acne conglobata.

We evaluated 10 patients with hidradenitis suppurative or acne conglobata who developed arthritis. In contrast to patients with acne fulminans and arthritis, all our subjects were adults over 22 years of age; nine were black; and four were women. Nine patients had episodic inflammatory oligoarthritis affecting mainly larger joints of the upper and lower extremities. Eight patients had roentgenographic evidence of peripheral arthritis, four with erosions. Nine had clinical axial arthropathy, but roentgenograms showed abnormalities of the axial skeleton in all 10 patients. Pyoderma gangrenosum, erythema nodosum, conjunctivitis, urethritis, and oral and penile ulcers occurred in some patients. Rheumatoid factor was negative in all patients; the erythrocyte sedimentation rate was elevated in nine; five had chronic anemia; four had circulating immune complexes; and complement components were elevated in four. There was no increased incidence of HLA-B27 or other HLA-B7 cross-reacting antigens. A temporal relation of skin and joint disease activity was suggested. We report a spondyloarthropathy associated with hidradenitis suppurativa and acne conglobata. Clinical and laboratory manifestations suggest the arthropathy may be reactive to chronic cutaneous infection.

Chronic Cutaneous Infection Caused by Mycobacterium intracellulare

A 53-year-old woman had multiple ulcerative skin lesions caused by Mycobacterium intracellulare. The original lesions had appeared on her face and upper part of her chest at least 11 years earlier and had progressed slowly to involve large areas of her head and trunk. This unusual skin infection demonstrates chronicity and destructiveness.

Chronic cutaneous infection caused by Mycobacterium intracellulare

Chronic cutaneous infection caused by Mycobacterium intracellulare

Lennert's lymphoma presenting with clusters of cutaneous infection

We recently diagnosed and studied a case of Lennert's lymphoma in a young black man who presented with a chronic pyoderma and multiple cutaneous infections of viral origin. Lennert's lymphoma, or malignant lymphoma with a high content of epithelioid histiocytes, is an uncommon variant of non-Hodgkin's lymphoma. This report highlights the role of idiopathic immunosuppression in lymphoma patients.

Vidarabine Therapy for Severe Herpesvirus Infections

Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.

Vidarabine therapy for severe herpesvirus infections. An unusual syndrome of chronic varicella and transient immunologic deficiency

Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.

SEVERE GENERALIZED BLASTOMYCETIC DERMATITIS

In May 1894 Gilchrist examined sections in which he first found blastomycetes. In November 1894 Busse 1 reported a case of systemic blastomycosis in which the diagnosis was confirmed by postmortem examination. In 1896 Gilchrist and Stokes 2 reported a case of chronic cutaneous oidium infection. The causative organism was found in pus and in sections of tissue. Inoculations of animals with fresh tissue gave negative results. The cultural characteristics of the organism were described, and in a subsequent report, in 1896, 3 this case was definitely classified as one of cutaneous blastomycosis. Since its recognition many therapeutic agents have been used in the treatment of the disease, and iodides have held a prominent place among these agents. Little attention has been given to the use of intravenous injections of compound solution of iodine U. S. P., as suggested by Ravaut, 4 in the treatment of this and other mycotic