Contents
Infective dermatitis is a severe, generalized inflammation of the skin that begins in childhood and is characterized by a chronic, recurrent course. It is postulated that it is an expression of immunodeficiency associated with HTLV-1 infection acquired early in life (most often vertically).
Epidemiology of infectious dermatitis
Infectious dermatitis occurs in regions endemic to HTLV-1 infection, particularly in Jamaica, Colombia, Brazil and Japan. It usually starts on the 2nd-3rd day of the week. years of age, in 60% of cases it concerns female patients.
Infective dermatitis – causes
Human T-cell lymphotropic virus type 1 (HTLV-1) contributes to the development of infectious dermatitis.
pathogenesis
Inflammatory lymphocytic infiltrates found in skin lesions are involved in the development of infectious dermatitis symptoms. HTLV-1 genetic material is detected in lymphocytes isolated from skin biopsies. Skin cells show increased production of pro-inflammatory cytokines induced by HTLV infection, which causes chronic inflammation in the skin.
Moreover, HTLV-1 infection leads to dysfunction of the patient’s immune system and in this mechanism to increased sensitivity to bacterial infections (mainly Staphylococcus aureus and Streptococcus). beta-hemolytic. About 30-35% of children develop complications of the disease, which include:
- corneal clouding,
- interstitial pneumonia,
- glomerulonephritis.
Some children develop other HTLV-12 related diseases such as ATLL and HAM / TSP after 25-1 years of disease.
What is infectious dermatitis like?
The disease in the form of infectious dermatitis is chronic, recurrent. There is usually a rapid improvement with the use of antibiotics, but the skin lesions reappear when they are discontinued. As the child grows up, the symptoms become less severe.
Infective dermatitis – diagnosis
The diagnosis of infectious dermatitis is based on:
- clinical picture,
- blood laboratory tests,
- skin biopsy assessment.
There is anemia, leukocytosis with the presence of atypical lymphocytes, increased ESR, increased immunoglobulin levels, increased percentages of CD4 + and CD8 + lymphocytes with an increased CD4 + to CD8 + ratio. Staphylococcus aureus and streptococci are often cultured from skin lesions beta-hemolytic. Lymphocytic inflammatory infiltrates and matter are found in skin biopsies. genetic HTLV-1. It is important to confirm HTLV-1 infection (children with infectious dermatitis have high levels of anti-HTLV-1 antibodies).
Differential diagnosis
The differential diagnosis should consider other forms and causes of dermatitis in children, in particular atopic dermatitis.
Methods of treating infectious dermatitis
Treatment of infectious dermatitis is to combat bacterial superinfections. The basis is the long-term use of targeted antibiotic therapy, effective against the bacterial flora found in skin lesions (Staphylococcus aureus, Ŕ-haemolytic streptococci). Such management is essential for disease control, and its discontinuation results in a rapid relapse. It is important to recommend methods of preventing HTLV-1 vertical infection.
What’s the prognosis?
The symptoms of infectious dermatitis become less severe as the child grows older. The condition for maintaining remission of the disease is the chronic use of antibiotics. Human T-cell lymphotropic viruses are also known to cause numerous inflammatory and autoimmune diseases in HTLV endemic areas. These include:
- arthritis,
- muscle inflammation,
- uveitis (with viral cells and infected lymphocytes in the vitreous)
- inflammation of the urinary and respiratory tract.
Patients with HIV / HTLV co-infection may pose a problem – research shows faster progression of HIV to AIDS and faster development of ATLL in people co-infected with HIV and HTLV.
In 2005, HTLV-3 and HTLV-4 viruses were isolated in Cameroonians. HTLV-3 is very similar to simian T-lymphotropic virus (STLV-3) and is likely to have been transmitted from monkeys to humans. The role of both types of virus in human pathology is unknown. Initially, HTLV-3 was defined as a virus isolated from AIDS patients. After it was found to be significantly different from other HTLV viruses, it was named HIV and classified as a different type of retrovirus.
Infective dermatitis – a summary
1. The retrovirus family includes the HTLV-1 and HTLV-2 human T-cell lymphotropic viruses, in addition to HIV.
2. About 15-25 million people worldwide are infected with HTLV, especially in Japan, the Caribbean, Africa and South America.
3. The HTLV-2 virus is mainly found among the indigenous people of the Americas.
4. Transmission of HTLV infection occurs through sexual contact, through infected blood, and vertically.
5. The clinical symptoms associated with HTLV infection develop in 1-5% of carriers, usually several dozen years after infection.
6.HTLV-1 is a recognized etiological factor of adult T-cell lymphoma / leukemia (ATLL), myelopathy / tropical spastic paralysis (HAM / TSP) and chronic inflammatory diseases of the skin (infectious dermatitis in children), uveal, joints, muscles and lungs.
For the care of inflammation-prone, sensitive and very sensitive skin, we recommend PRODEX SENSITIVE wipes or PRODEX SENSITIVE liquid. The cosmetics perfectly cleanse the skin of the face and have soothing properties.
Literature
1. Mofenson L.M.: Human Retroviruses. Oncoviruses (Human T-Cell Lymphotropic Viruses Types I and II), [w:] Feigin R.D., Cherry J.D., Demmler G.J., Kaplan S.L. (red.): Textbook of Pediatric Infectious Diseases, Saunders, Philadelphia 2004, str. 2424-2455 (wyd. V).
2. Novitsky V., Shapiro R., Essex M.: Human Retroviruses, [w:] Gorbach S.L., Bartlett J.G., Blacklow N.R. (red.): In fectious Diseases, Lippincott Williams & Wilkins, Philadelphia 2004, 2082-2105 (wyd. III).
3. Coombs R.W.: Human Retroviral Infections: Human T Cell Lymphotropic Viruses. HTLV-I. ACP Medicine Online, 2002. http://www.medscape.com.
4. Murphy E.L., Wang B., Sacher R.A. i wsp.: Respiratory and Urinary Tract Infections, Arthriris, and Asthma Associated with HTLV-I and HTLV-II Infections, Emerg Inf Dis 2004.
5. Lairmore M.D., Fujii M.: 12th International Conference on Human Retrovirology: HTLV and Related Retroviruses, Retrovirology 2005; 2:61.
Source: J. Cianciara, J. Juszczyk, Infectious and parasitic diseases; Czelej Publishing House