Article (Scientific journals)
Occult Herpes Simplex Virus Colonization of Bullous Dermatitides
Nikkels, Arjen; Delvenne, Philippe; Herfs, Michael et al.
2008In American Journal of Clinical Dermatology
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Keywords :
Herpes simplex virus; HSV; Bullous Dermatitides
Abstract :
[en] Background: Acantholytic disorders, including pemphigus vulgaris, chronic benign familial pemphigus (Hailey-Hailey disease), Darier disease, and Grover transient acantholytic dermatosis, as well as other vesiculobullous disorders, including bullous pemphigoid, epidermolysis bullosa, and atopic dermatitis, are prone to florid infections by herpes simplex virus (HSV)-I and -II, and, more rarely, by varicella-zoster virus (VZV). As these infections are difficult to recognize clinically and histologically, their frequency remains unknown. A possible occult viral colonization has never been documented in these disorders. The manner in which the primary bullous disorders are contaminated by herpesviridae remains unclear. Objective: To retrospectivally assess the possible presence of HSV and VZV in a series of biopsies of acantholytic disorders and bullous pemphigoid. Method: The typical a-herpesviridae-related cytopathic signs were searched for by conventional microscopy in skin biopsies of patients with pemphigus vulgaris (n = 19), bullous pemphigoid (n = 20), Darier disease (n = 18), Hailey-Hailey disease((Author: is this the same as superficial pemphigus, as mentioned in both Histology sections?)) (n = 3), and Grover transient acantholytic dermatosis (n = 3). Immunohistochemistry (IHC) targeted specific HSV-I, HSV-II, and VZV antigens. Polymerase chain reaction (PCR) was used for detecting HSV- and VZV-specific DNA sequences. Results: No cytopathic signs suggestive of HSV or VZV infection were detected. However, IHC revealed HSV antigens in Darier disease (1/18, HSV-I), Grover transient acantholytic dermatosis (1/3, HSV-I), pemphigus vulgaris (1/20((Author: 1/19 in the Immunohistochemistry section?)), HSV-I), and bullous pemphigoid (2/ 20, HSV-I and HSV-II). In these IHC-positive cases, PCR amplified specific HSV primers in Darier disease (1/ 18), pemphigus vulgaris (1/20((Author: 1/19 in the PCR section?))), and bullous pemphigoid (1/20). VZV antigens and nucleic acids were never identified. The HSV antigens were ((Author: nearly always, as in the Immunohistochemistry section?)) restricted to the upper part of the granular layer and thus differed from the usual HSV distribution during cutaneous infection. Negative and positive controls yielded consistently positive and negative results, respectively.((Author: OK?)) Conclusion: This report shows for the first time that clinically and histologically occult HSV colonization may occur in Darier disease, Grover transient acantholytic disease, pemphigus vulgaris, and bullous pemphigoid. Given the frequent use of immunosuppressive treatments for primary bullous disorders, greater awareness of HSV colonization and infection is recommended in these patients.
Disciplines :
Dermatology
Author, co-author :
Nikkels, Arjen ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Delvenne, Philippe ;  Centre Hospitalier Universitaire de Liège - CHU > Anatomie pathologique
Herfs, Michael ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Pierard, Gérald ;  Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Language :
English
Title :
Occult Herpes Simplex Virus Colonization of Bullous Dermatitides
Publication date :
2008
Journal title :
American Journal of Clinical Dermatology
ISSN :
1175-0561
eISSN :
1179-1888
Publisher :
Adis International, Auckland, New Zealand
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 27 February 2009

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