The antibiotic-induced eruption of infectious mononucleosis is a well-known clinical phenomenon. Latent viral infection with herpesviridae (eg, human herpes virus 6 (HHV-6) and Epstein-Barr virus (EBV)) is suspected t...The antibiotic-induced eruption of infectious mononucleosis is a well-known clinical phenomenon. Latent viral infection with herpesviridae (eg, human herpes virus 6 (HHV-6) and Epstein-Barr virus (EBV)) is suspected to play a role in the drug hypersensitivity syndrome. The cutaneous pathologic findings have not been reported in the former, and are infrequently reported in the latter entity. Herein, we describe the biopsy findings of a cefprozil-induced rash in infectious mononucleosis and a minocycline-associated drug hypersensitivity syndrome. Biopsy of these exanthematous eruptions revealed an acute vacuolar interface superficial and deep perivascular and interstitial lymphocytic dermatitis. CD8+lymphocytes predominated and were associated with non-neutrophilic nuclear (karyorrhectic) debris and numerous small CD68+and CD123+monocytes. These aforementioned features have been described in cutaneous lesions of Kikuchi-Fujimoto disease, an entity whose clinicopathologic findings overlap with both infectious mononucleosis and lupus erythematosus. Serologic evidence of active and chronic active EBV infection was found in both patients, respectively. No evidence of EBV or HHV6 was found in the cutaneous lesions. Plasmacytoid monocytes (CD68+/CD123+cells), which produce type I interferon, are believed to play a role in viral immunity by protecting other cells from viral infections and promoting survival of antigenactivated T cells. Their presence in these two putative examples of viral-drug immune dysregulation could be a clue to pathogenesis and represent a common cellular component of some adverse cutaneous drug eruptions.展开更多
Several studies have investigated the possible involvement of viral agents,and among them herpes viruses,in the development of cutaneous T- cell lymphoma. The aim of our study was to determine whether T- cells specifi...Several studies have investigated the possible involvement of viral agents,and among them herpes viruses,in the development of cutaneous T- cell lymphoma. The aim of our study was to determine whether T- cells specific to Epstein- Barr virus(EBV)- antigens were detectable among tumor- infiltrating lymphocytes infiltrating cutaneous lesions of a patient with Sé zary syndrome. To analyze responses to EBV, we used a transient SV- 40 origin- defective transformed simian cells transfection assay that permits an estimation of CD8 T- cell responses against a large number of HLA/viral protein combinations. This technique allowed the detection of EBV- specific T lymphocytes mainly directed against epitopes generated during the lytic cycle in the cutaneous lesions. This is, to our knowledge,the first descrip- tion of the presence of EBV- specific T lymphocytes among tumor- infiltrating lymphocytes infiltrating the lesional skin of a patient with Sé zary syndrome.展开更多
文摘The antibiotic-induced eruption of infectious mononucleosis is a well-known clinical phenomenon. Latent viral infection with herpesviridae (eg, human herpes virus 6 (HHV-6) and Epstein-Barr virus (EBV)) is suspected to play a role in the drug hypersensitivity syndrome. The cutaneous pathologic findings have not been reported in the former, and are infrequently reported in the latter entity. Herein, we describe the biopsy findings of a cefprozil-induced rash in infectious mononucleosis and a minocycline-associated drug hypersensitivity syndrome. Biopsy of these exanthematous eruptions revealed an acute vacuolar interface superficial and deep perivascular and interstitial lymphocytic dermatitis. CD8+lymphocytes predominated and were associated with non-neutrophilic nuclear (karyorrhectic) debris and numerous small CD68+and CD123+monocytes. These aforementioned features have been described in cutaneous lesions of Kikuchi-Fujimoto disease, an entity whose clinicopathologic findings overlap with both infectious mononucleosis and lupus erythematosus. Serologic evidence of active and chronic active EBV infection was found in both patients, respectively. No evidence of EBV or HHV6 was found in the cutaneous lesions. Plasmacytoid monocytes (CD68+/CD123+cells), which produce type I interferon, are believed to play a role in viral immunity by protecting other cells from viral infections and promoting survival of antigenactivated T cells. Their presence in these two putative examples of viral-drug immune dysregulation could be a clue to pathogenesis and represent a common cellular component of some adverse cutaneous drug eruptions.
文摘Several studies have investigated the possible involvement of viral agents,and among them herpes viruses,in the development of cutaneous T- cell lymphoma. The aim of our study was to determine whether T- cells specific to Epstein- Barr virus(EBV)- antigens were detectable among tumor- infiltrating lymphocytes infiltrating cutaneous lesions of a patient with Sé zary syndrome. To analyze responses to EBV, we used a transient SV- 40 origin- defective transformed simian cells transfection assay that permits an estimation of CD8 T- cell responses against a large number of HLA/viral protein combinations. This technique allowed the detection of EBV- specific T lymphocytes mainly directed against epitopes generated during the lytic cycle in the cutaneous lesions. This is, to our knowledge,the first descrip- tion of the presence of EBV- specific T lymphocytes among tumor- infiltrating lymphocytes infiltrating the lesional skin of a patient with Sé zary syndrome.
