Human T cell lymphotropic virus type I-associated infective dermatitis in Jamaica: a case report of clinical and biologic correlates

Citation
Em. Maloney et al., Human T cell lymphotropic virus type I-associated infective dermatitis in Jamaica: a case report of clinical and biologic correlates, PEDIAT INF, 19(6), 2000, pp. 560-565
Citations number
38
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Clinical Immunolgy & Infectious Disease
Journal title
PEDIATRIC INFECTIOUS DISEASE JOURNAL
ISSN journal
0891-3668 → ACNP
Volume
19
Issue
6
Year of publication
2000
Pages
560 - 565
Database
ISI
SICI code
0891-3668(200006)19:6<560:HTCLVT>2.0.ZU;2-0
Abstract
Infective dermatitis was first characterized in Jamaican children as an exu dative and crusting eczema (involving the nostrils, ears and scalp) with fr equent relapse after treatment.(1, 2) In 1990 a case series of infective de rmatitis from Jamaica provided the first link with early life infection wit h human T cell lymphotropic virus type I (HTLV-I).(3) A subsequent case-con trol study confirmed this association and established criteria for diagnosi s of HTLV-I-associated infective dermatitis.(4) The diagnostic criteria inc lude HTLV-I seropositivity; eczema of at least two of seven sites (scalp, e xternal ear, retroauricular areas, eyelid margins, paranasal skin. and/or n eck, axillae, groin); chronic watery nasal discharge without other signs of rhinitis and/or crusting of the anterior nares; and either early childhood onset or chronic relapsing dermatitis.4 The prevalence of HTLV-I in the ge neral population of Jamaica is 6.1%, and among women of reproductive age it is 3.8%.(5, 6) In Jamaica maternal-child transmission occur; at a rate of 18%, is primarily through breast-feeding and results in a HTLV-I prevalence of <2% among children younger than 10 years of (5, 6) Cases of infective d ermatitis in HTLV-I-age. infected children have also been reported in Japan , Brazil, Colombia and Trinidad.(7-10) Infective dermatitis is the earliest disease manifestation of HTLV-I infect ion in children, whereas adult T cell leukemia/lymphoma and HTLV-I-associat ed myelopathy/tropical spastic paraparesis and HTLV-I-associated uveitis oc cur primarily among adults.(11) Linking these childhood and adult diseases are reports that patients with adult T cell leukemia/lymphoma and those wit h HTLV-I-associated myelopathy/tropical spastic paraparesis had been diagno sed with infective dermatitis 12 to 25 years earlier.(7, 12, 13) Thus infec tive dermatitis in childhood may be a harbinger of HTLVI-associated disease s in adult life. In this report we describe an infective dermatitis case that arose among 28 HTLV-I-infected Jamaican children prospectively followed for up to 9 years to elucidate events leading to the onset of disease and to identify potent ial markers for persons at risk for HTLV-I-associated disease in adulthood.