Dermatological Manifestations In Patients Research Articles

Dermatological Manifestations in Patients With Chronic Kidney Disease: A Review.

Chronic kidney disease (CKD) is a progressive disease and has multiple clinical manifestations; when CKD reaches the end stage, at least one cutaneous manifestation appears due to some increased toxin levels or a constant proinflammatory state. Nonspecific manifestations include pruritus, xerosis, pigmentation disorders, acquired ichthyosis, purpuric spots, and nail disorders. Some specific manifestations are bullous dermatoses, acquired perforating dermatoses (APD), eruptive xanthoma, access site infections, calcifying disorders, and nephrogenic systemic fibrosis (NSF). All these cutaneous changes negatively impact patients; early recognition and diagnosis of these dermatoses will make a difference in their quality of treatment. Exploring a patient's skin is fundamental to suspect some diseases and increased toxin levels; pruritus occurs when uremic toxins are raised, and nail disorders are associated with hypoalbuminemia. This review provides the clinician with information on the clinical manifestations that occur in CKD, including epidemiology, pathophysiology, clinical manifestations, diagnosis, histopathology, treatment, and life impact of the dermatoses in CKD.

A Cross-Sectional Study of Dermatologic Manifestations in Patients with Chronic Renal Failure on Hemodialysis

Background: Chronic renal failure patients undergoing dialysis suffer from various side effects and complications where skin ailments are one of them. Skin is the largest and one of the most dynamic organs of the body and can be used as a window since it is easily accessible for observation and reflects changes seen in multiple organs including kidneys. Objective: The objective of this study is to describe various cutaneous manifestations in chronic kidney disease patients undergoing hemodialysis. Materials and Methods: A hospital-based, cross-sectional, observational study was conducted in the department of dermatology, venereology, and leprosy at a tertiary care center from November 2019 to May 2021. The demographic details and clinical manifestations were recorded. Data were recorded as numbers and percentages. For categorical data, the number and percentage were used in the data summaries, and data were analyzed by the Mann‒Whitney U test for the comparison of two data. Results: A total of 94 patients were included in the study. The most common manifestation observed was pruritus (85.1%), followed by xerosis (84%). Other findings seen in the study were mainly nonspecific changes such as pallor (59.57%), diffuse hyperpigmentation (3.2%), and ecchymosis (16%). Nail changes (56.38%) observed were half-and-half nails (22.6%), onycholysis (11%), and Beau’s lines (9%). Mucosal changes (36.17%) included depapillated tongue (12.8%) and macroglossia (8.5%). Other findings such as skin infections and keloid were also noted. New finding such as angina bullosa hemorrhagica was seen in one patient. Specific change like Kyrle’s disease was seen in 6.4% of the study group and 50% of these patients had concomitant diabetes mellitus. Conclusion: Patients on hemodialysis present with an array of cutaneous manifestations. The most common include pruritus and xerosis. Prompt diagnosis and early treatment help alleviate many of the cutaneous manifestations posed due to hemodialysis.

Cutaneous susceptibility to SARS-CoV-2 infection according to the expression of viral entry factors in the skin

Introduction: Reports of dermatological manifestations in patients with COVID-19 suggest a possible cutaneous tropism of SARS-CoV-2; however, the capacity of this virus to infect the skin is unknown. Objective: To determine the susceptibility of the skin to SARS-CoV-2 infection based on the expression of viral entry factors ACE2 and TMPRSS2 in this organ. Method: A comprehensive analysis of human tissue gene expression databases was carried out looking for the presence of the ACE2 and TMPRSS2 genes in the skin. mRNA expression of these genes in skin-derived human cell lines was also assessed. Results: The analyses showed high co-expression of ACE2 and TMPRSS2 in the gastrointestinal tract and kidney, but not in the skin. Only the human immortalized keratinocyte HaCaT cell line expressed detectable levels of ACE2, and no cell line originating in the skin expressed TMPRSS2. Conclusions: Our results suggest that cutaneous manifestations in patients with COVID-19 cannot be directly attributed to the virus. It is possible that cutaneous blood vessels endothelial damage, as well as the effect of circulating inflammatory mediators produced in response to the virus, are the cause of skin involvement.

Dermatologic manifestations in patients with the Hermansky–Pudlak syndrome types 1 and 3

BackgroundThe Hermansky–Pudlak syndrome (HPS) is a genetically heterogeneous group of diseases characterized by oculocutaneous albinism, bleeding diathesis, and systemic complications. It is the most common genetic disorder in Puerto Rico. These patients are at a significant risk of developing a variety of skin complications and little is known about the prevalence of dermatologic diagnoses in this population.ObjectivesTo report dermatologic manifestations in patients with Hermansky–Pudlak syndrome (HPS). Secondary aims include skin concerns, sun protection habits, barriers to dermatologic care, and skin cancer knowledge.MethodsCross-sectional study with twenty-nine Puerto Rican patients who carried a clinical diagnosis of HPS type 1 or type 3 through a telephonic questionnaire.ResultsTwenty-nine patients participated with a mean (SD) age of 37.3 (16.8) years and the majority were female (69%). The most common diagnoses were skin cancer (34.5%), acne (34.5%), bacterial skin infections (34.5%), warts (24%), urticaria (17.2%), and psoriasis (17.2%). The most common skin concerns were dry skin (62.1%), hair loss (58.9%), redness (34.5%), moles (31%), and rash (31%). The most common sun protection behavior was wearing a shirt that covers the shoulders (93.1%, often or always) and the least common was wearing a hat (24.1%, often or always). Higher income was significantly associated with being more likely to use sunscreen often or always (OR = 3.38, 95% CI 1.02–11.18, p = 0.04). Those in northern urban areas were significantly less likely to report barriers to dermatologic care (OR = 0.13, 95% CI 0.02–0.76, p = 0.02).ConclusionsThis study provides an important overview of the most common self-reported skin manifestations in patients with HPS. Unfortunately, a high prevalence of cutaneous malignancy was reported. The results stress the need for adequate care and potential interventions to promote sun protection behaviors and skin cancer prevention.

POS-706 PSEUDOPORPHYRIA IN A PERITONEAL DIALYSIS PATIENT

Dermatological manifestations in patients with end-stage renal disease (ESRD) are very common, such as pruritus, xerosis and pigmentation disorders, other skin disorders are quite rare such as pseudoporphyria cutanea tarda (PCT). It is a photodistributed vesicobullous disorder with clinical and histologic features similar to those of porphyria cutanea tarda but without accompanying biochemical porphyrin abnormalities. Although PCT is seen in 13% of hemodialysis patients, it is rare in peritoneal dialysis (PD) patients.

345. Dermatological Manifestations in Patients with COVID-19 Pneumonia in Veracruz, Mexico

BackgroundA large number of viral infections are characterized by the presence of cutaneous manifestations. Multiple dermatological manifestations have been observed in patients with COVID-19. Dermatological lesions in patients infected by SARS-CoV-2 such as livedo reticularis, rash and vascular lesions may represent manifestations of secondary phenomena such as paraviral rashes or by participation of the innate or adaptive immune system that cause vasodilation, vascular leakage or procoagulant effectsMethodsDescriptive and observational study, adult patients with COVID-19 pneumonia were selected, confirmed by RT-PCR and chest CT. General symptoms, hematic cytometry results, pneumonia severity, prognosis as well as dermatological manifestations are characterized.Results100 patients were entered into the study, with an average age of 49.4 years, 54% male. The general symptoms with the highest incidence were: fever, cough and dyspnea characteristic of SARS-CoV-2 infection, followed by chest pain, headache, anosmia and dysgeusia. The main alteration of the hemogram was lymphopenia, no leukopenia or plaquetopenia was demonstrated. 54% of those affected had mild pneumonia, the rest severe pneumonia. 75% progressed towards improvement and 25% died. Among the dermatological manifestations identified, all occurred in cases with severe pneumonia, the one with the highest incidence was the morbilliform viral exanthema in 18%, the presence of diffuse partial alopecia in 7% as well as manifestations of lividity and maceration in 1%. Regarding alopecia, in 6% it was reversible androgenetic alopecia, having manifested during the acute stage of pneumonia (all men), in 1% it presented alopecia areata (male) that has been persistent beyond the acute phase and in frank recoveryDemographic and clinical variables Clinical manifestations ConclusionThe incidence of dermatological manifestations is low in this study population, the most frequent being the morbilliform viral exanthema expected in a virus, however they present manifestations of low incidence such as reversible androgenetic alopecia associated with severity of the disease, a finding that has been documented recently as a manifestation associated with COVID-19Disclosures All Authors: No reported disclosures

Cutaneous manifestations of small fibre polyneuropathy.

Because typical and atypical features of small fibre polyneuropathy (SFN) in the skin have not been fully elucidated, the diagnosis is often made by the exclusion of alternative conditions rather than by its identification as a primary syndrome. The objective of this study was to characterize dermatologic manifestations in patients with SFN. Large retrospective series of biopsy-proven SFN cases seen at the Massachusetts General Hospital and Brigham and Women's Hospital (January 2000 to December 2019). The majority of the 301 participants included presented with at least one cutaneous manifestation [292/301 (97%)]. Pain was most common with 254/301 (84.4%) perceiving this as occurring in the skin. It was frequently described as 'burning' [95/254 (37.4%)] and affected distal [174/254 (68.5%)] slightly more than proximal [111/254 (43.7%)] limbs. Numbness [182/301 (60.5%)], edema [61/301 (20.3%)] and skin colour changes [53/301 (17.6%)], which include redness [23/53 (43%)], also had predominant distal distribution. Characteristic loss of distal hair occurred among 17/29 (59%) those reporting hair loss. Other findings with classic limb involvement, Raynaud's phenomenon [33/301 (11%)] and erythromelalgia [26/301 (8.6%)] were seen. Itch [45/301 (15%)], mostly localized [22/45 (49%)] and localized eczematous dermatitis were also found. SFN has a wide range of clinical features in which the skin is affected, with characteristic findings affecting the extremities.

Cutaneous manifestations of end-stage renal disease

Objectives: (1) To study the dermatological manifestations in patients with end-stage renal disease (ESRD) of diverse etiology and (2) to compare the dermatological manifestations in patients on conservative treatment and those receiving hemodialysis. Materials and Methods: One hundred patients with ESRD who attended the nephrology/dermatology department of a tertiary care center were examined for dermatological manifestations. Results: All the 100 patients evaluated had at least one cutaneous manifestation. Pallor was the most common cutaneous finding in our study (64%). Xerosis was observed in 61% and pruritus in 46%. Other common findings included diffuse hyperpigmentation (22%) and cutaneous infections (20%). Specific changes noted were acquired perforating dermatoses (7%) and nephrogenic systemic fibrosis (2%). Nail, oral mucosa, and hair were affected in 61%, 54%, and 29% cases, respectively. No significant association was noted between dermatological manifestations and modality of treatment. Comparison of serum calcium, serum phosphorus, and calcium-phosphate product was done with pruritus and a significant association was noted between pruritus and the serum levels of phosphate and calcium-phosphate product. Limitations: Small sample size and the single center study design were the major limitations. Conclusion: Dermatological manifestations are common among patients with ESRD. Early diagnosis and prompt management of the dermatological diseases may improve the quality of life of the affected.

POS-581 PSEUDOPORPHYRIA CUTANEA TARDA IN HEMODIALYSIS

Although dermatological manifestations in patients with end-stage renal disease (ESRD) are very common, such as pruritus, xerosis and pigmentation disorders, other skin disorders are quite rare such as pseudoporphyria cutanea tarda (PCT). It is a bullous photodermatosis with the same clinical and histological characteristics of porphyria cutanea tarda but in the absence of abnormalities in the metabolism of porphyrin. We report in this work 2 cases of ESRD patients who developed a PCT. We report in this work 2 cases of ESRD patients who developed a PCT in our hemodialysis (HD) unit. Case report 1: A 49-year-old man with a history of Marfan syndrome complicated by bilateral blindness and hypertension and ESRD secodary to an indeterminate nephropathy. He started HD in 2007. His renal failure was complicated by secondary hyperparathyroidism requiring 7/8 parathyroidectomy associated with total thyroidectomy because of the presence of a Tirads V classified thyroid nodule. After 10 years of HD, he developed a bullous dermatosis, a fragile skin with multiple erosions covered with brownish scabs. The lesions were localized in the photo-exposed areas : the face and the hands. He had no family history of porphyria, photosensitivity, or previous episodes of this dermatosis. The diagnosis retained was PCT of the dialysis patient. Ferritin was within the standards at this time. The treatment was based on N-acetylcysteine and photoprotective creams. The outcome was favorable with the disappearance of the bullous lesions leaving multiple atrophic and dyschromic scars without subsequent recurrence. Case report 2: A 48 year old man with a history of hypertension, diabetes, ESRD on indeterminate nephropathy. He started peritoneal dialysis in 2010. After 9 years, faced with recurrent peritonitis, he was switched to HD. Encapsulating peritonitis was diagnosed after starting HD, treated with tamoxifen and corticosteroids. After one year of HD, he developed bullous skin lesions with the presence of folliculitis on the back of his hand, arm and abdomen. Biologically, there was no biological inflammatory syndrome and the ferritin was at 212ng / ml. He was initially treated by local and systemic antibiotic therapy, but without improvement. The diagnosis subsequently retained was PCT of the dialysis patient and he was treated with N acetylcysteine, the prescription of photoprotection and antibiotic therapy for his surinfected lesions. The evolution was marked by the progressive regression of the lesions giving way to atrophic scars. There are multiple factors that can cause a push of PCT in dialysis patients, such as erythropoietin, iron overload, diuretics, but the cause may remain unknown. The main thing is to always think about this diagnosis in face of any bullous dermatosis and knowing how to stop the incriminating agent, prescribe photoprotection, in addition to N acetylcysteine having encouraging results in these patients.

The effect of gluten on skin and hair: a systematic review

Non-celiac gluten sensitivity is often clinically indistinguishable from celiac disease, and patients show improvement or resolution of their symptoms with a gluten-free diet. In contrast to celiac disease, the effects of gluten on the skin and hair in the context of non-celiac gluten sensitivity are not as clear. This review aims to describe the impact of gluten on the skin and hair in patients with non-celiac gluten sensitivity and those without a definitive celiac disease diagnosis. A literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guidelines for systematic reviews. Forty-two publications met inclusion criteria with five studies describing the skin manifestations of non-celiac gluten sensitivity. Trials identifying the impact of a gluten-free diet on skin disease, as well as dermatologic conditions and their associations with antigliadin antibodies were also identified. Dermatologic manifestations in patients with non-celiac gluten sensitivity vary and may be non-specific. It may be appropriate for some of these patients with skin manifestations to trial a gluten-free diet. Dermatologic conditions that may respond positively to a gluten-free diet include psoriasis, atopic dermatitis, vitiligo, and palmoplantar pustulosis, while linear IgA disease does not appear to improve with this dietary change.

Dermatological Manifestations in Patients with COVID-19 Pneumonia in Veracruz, Mexico

A large number of viral infections are characterized by the presence of cutaneous manifestations. Multiple dermatological manifestations have been observed in patients with COVID-19, however, among the main challenges that dermatology faces is the difficult relationship between the appearance of dermatological lesions with the infection itself, as well as the poor description of the lesions that are normally determined only as .

The Dermatological Manifestations in the Coronavirus Infection COVID-19

The variety of dermatological manifestations in patients with the novel coronavirus infection COVID-19, the incidence of which depends on concomitant pathology and the characteristics of drug treatment, and their characteristics are similar to those that occur with conventional viral infections is discussed. At the present time it is proposed to distinguish several groups depending on the cause and mechanism of development: angiitis of the skin; papulo-squamous rash and pink lichen; measles rash and infectious erythema; papulo-vesicular rash; toxidermia; urticarial eruptions and artifical lesions. The variety of the clinical picture of the skin manifestations of coronavirus infection requires in-depth analysis in order to interpret correctly the skin lesions and other infectious exanthema and dermatoses in patients with COVID-19.

Dermatologic manifestations in patients with polycystic ovary syndrome: their prevalence and assessment in relation to hormonal and metabolic changes

Polycystic ovary syndrome(PCOS) is considered the most common endocrine disorder affecting females in the reproductive years,and is characterized by being multisystemic with a variety of phenotypes and broad spectrum of manifestations that are strongly influenced by ethnic backgrounds. Cutaneous manifestations represent an important part of the syndrome.The aim of this study was to detect the prevalence of dermatologic manifestations among an Egyptian PCOS cohort and to study the correlation between these manifestations and the underlying hormonal and metabolic changesThe study was conducted on 53 patients diagnosed as PCOS aged 20-40 years and 50 non-PCOS controls of the same age group .In all participants history was taken including family, medical, drug and menstrual history. Anthropometric measurments were recorded and they were subjected to pelvic ultrasonography and to dermatologic examination focusing on hirsutism, acne, androgenetic alopecia and acanthosis nigricans. total Testosterone, free testosterone, DHEAS, prolactin and TSH were measured for the PCOS group. Additionally, the HOMA-IR for insulin resistance was calculated. Among the PCOS patients group prevalence percent of hirsutism 49%, followed by AGA 43.3%, , acne 39.6%and acanthosis nigricans 32% .Having hirsutism in PCOS patients was associated with higher levels of total and free testosterone than being free from hirsutism. the degree of hirsutism (mFGS) showed a weak positive correlation with the serum levels of total and free testosterone. Acne and AGA in PCOS patients seem not to be influenced by serum androgen levels, HOMA-IR nor anthropometric measures..Acanthosis nigricans is more related to the metabolic disorder rather than to hyperandrogenism.

Dermatologic manifestations of COVID-19-associated multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children (MIS-C) affects a small percentage of pediatric patients infected with COVID-19 and is characterized by fever, laboratory evidence of inflammation, multisystem involvement, and severe illness necessitating hospitalization. Skin findings are often present in these patients, and when initially compared with Kawasaki disease, they likely represent distinct phenomena and overall remain poorly characterized. In this retrospective review of 34 case reports and series, we identified cutaneous manifestations documented in 417 of 736 patients (57%) with MIS-C associated with COVID-19. “Rash” was the sole descriptor of skin findings in nearly half of patients. Case reports and smaller case series provided more detail, outlining a broad range of lesion morphologies (polymorphic, maculopapular, morbilliform, erythrodermic, urticarial, reticular, petechial, purpuric) in variable anatomic distribution. More thorough descriptions of dermatologic manifestations in patients with MIS-C are warranted to better characterize this syndrome, as they may lend important insight into pathogenic mechanisms of disease.

Dermatological Manifestations in Patients of Chronic Kidney Disease (CKD)

Background: CKD is associated with various mucocutaneous manifestations that impair the quality of life.The objective was to study the incidence of various cutaneous manifestations in CKD patients.Materials and Method: 130 (M:F = 4.2:1) patients aged 15?78 (Mean age- 50.32 years) having CKDfor 3 month to 5 years were studied for mucocutaneous manifestations. Forty (30.7%) patients were onhemodialysis for 1-3 months. Detailed medical history, clinical and mucocutaneous examination and labinvestigations were performed. KOH mounts, skin biopsy, Gram’s and Giemsa staining, bacterial or fungalcultures were performed as required.Results: Xerosis in 104 patients (80%), skin pallor in 76(58.4%), pruritus in 52 (50.9%) patients, pigmentationin 45(34.6%) and purpura in 12 (9.2%) patients were the major dermatoses. Perforating folliculitis occurredin1 (0.76%) patient..Mucosal findings included coated tongue in14(11.66%), xerostomia in 11(9.16%) andmacroglossia with teeth markings and fissured tongue in 9 (7.5%) patients each, angular cheilitis in 3 (2.5%),and aphthous stomatitis and black pigmented tongue in 1 (0.83%) patients each. Hair abnormalities includedsparse scalp and body hairs in 43 (33%), 11 (8.4%), respectively and lusterless hair in 22 (16.9%) patients.Major nail abnormalities were half and half nails or Linday’s nails in 33(25.3%), longitudinal ridging in29(22.3%), leuconychia in 13(10%), onycholysis in 9(6.9%), Beau’s lines in 6(4.6%), koilonychias in4(3.07%), Mee’s lines in 1(0.76%) and Meuhrcke’s lines in 1(0.76%).Conclusions: Xerosis, pruritus, skin pallor/pigmentary changes, half and half nails, longitudinal ridging,discoloration, sparse hairs, coated tongue, xerostomia, macroglossia, and infections were the most commonmucocutaneous manifestations in the studied patients irrespective of hemodialysis status.

Dermatological manifestations in patients with end-stage renal disease at the hemodialysis center in merjan hospital at Babylon province, Iraq

Dermatological manifestations in patients with end-stage renal disease at the hemodialysis center in merjan hospital at Babylon province, Iraq

Diagnosis and treatment of dermatologic diseases in inflammatory bowel disease.

Dermatologic manifestations in patients with inflammatory bowel disease (IBD) are increasingly recognized as related disorders, secondary to specific therapies used to treat IBD, or complications of IBD itself. These dermatologic manifestations can be difficult to manage. We summarize three categories of dermatologic manifestations in this review: extraintestinal cutaneous disorders, paradoxical manifestations to biologic therapies, and other drug-induced cutaneous manifestations. In particular, we provide current data surrounding clinical characteristics, epidemiology, and treatment modalities for individual cutaneous manifestations. Many extraintestinal cutaneous manifestations can be managed by optimized treatment of IBD itself, as shared treatment pathways exist. Paradoxical reactions to biologic agents may be driven by the individual biologic therapy. In these instances, if topical therapies or immunomodulators are not effective in treating the paradoxical cutaneous reaction, a change of class may be required. Nonmelanoma and melanoma skin cancers have been linked to specific therapies for IBD (including thiopurines and antitumor necrosis factor alpha agents, respectively). Therefore, optimizing preventive efforts towards skin cancer is warranted. Recognition of these cutaneous disorders by the practicing gastroenterologist is important, as is collaboration with dermatology for management of many cutaneous disorders.

An Observational Study of Dermatological Manifestations in Patients of Chronic Renal Failure Undergoing Hemodialysis

Background: Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis. Methods: ninty three .. patients with CRF on hemodialysis were examined for cutaneous changes. Results: all the patients complained of some skin problem. The most prevalent finding was xerosis (54.8%), followed by pallor (21.5%), pruritus (19.35%) and cutaneous pigmentation (18.3%). Other cutaneous manifestations included Kyrle's disease (5.4%); fungal (5.4%), bacterial (6.5%) and viral (3.2%) infections; purpura (9.7%). The nail changes included half and half nail (21%), koilonychia (39.78%), onychomycosis (1.08%), onychorrhexis (6.45%), splinter hemorrhages (1.08%), and Beau's lines (2%). Hair changes included sparse hair (18.28%), and brittle and lusterless hair (11.83%). Oral changes included macroglossia with teeth markings (23.65%), . Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were not observed. Conclusions: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.

Dermatologic Manifestations in Patients on Chronic Hemodialysis

Dermatologic Manifestations in Patients on Chronic Hemodialysis

Dermatological manifestations in patients with human T-cell lymphotropic virus at a reference service in Amazon.

Individuals infected with the human T-cell lymphotropic virus type 1 (HTLV-1) commonly present skin lesions, which may be a warning sign for the diagnosis of infection. This study describes the most prevalent skin manifestations in HTLV carriers attended at the clinic of Núcleo de Medicina Tropical (NMT) of the Universidade Federal do Pará (UFPA) in Belém, Pará, Brazil. This is a study of a series of cases of patients infected with human T-cell lymphotropic virus types 1 and 2 (HTLV-1/2) treated at NMT UFPA between 1999 and 2016. A descriptive analysis of data was applied. Among 788 surveyed medical records in the service, 15.10% (n = 119) were referred to the dermatology clinic. From the series of cases that presented with skin lesions, 66.39% were female and 33.61% were male, and the average age of this group was 48 years. There was a predominance of patients with noninfectious inflammatory manifestations (64.2%), followed by infectious ones (24.6%), and 1.58% with lymphoproliferative diseases. As for the group of lesions, 45.26% of the erythematous-squamous type were observed, followed by dyschromia (24.21%), and eczematous (14.74%). One patient with a diagnosis of adult T-cell leukemia/lymphoma, another with parapsoriasis, and four with infective dermatitis are highlighted. Skin disorders in the HLTV positive patient are important causes of referral to the dermatologist with etiological and skin lesions groups diversity. In the series of cases studied, lymphoproliferatives diseases and infective dermatitis associated with HTLV-1 were presented as a challenge for the diagnosis and clinical management of these patients.