Original Article

Dermatologic Manifestations in HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

Abstract

The human T cell lymphotropic virus type-1 (HTLV-1) is associated with adult T cell leukemia/lymphoma (ATL) and other disorders, including a slowly progressive demyelinating paraparesis, known as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Dermatologic manifestations are common in patients infected with HTLV-1 infection. In this study, we evaluated the dermatologic lesions associated with HAM/TSP patients in Mashhad, Iran. Dermatological findings of 37 patients with HAM/TSP were investigated and compared with those of an HTLV-1 negative control group. A cutaneous biopsy was performed as needed, and the results were statistically analyzed. Results of the present study showed that 34 cases with HAM/TSP (91.9%) and 24 cases in the control group (64.9%) had at least one skin lesion or history of skin lesion before (P=0.010). Xerosis was found in 22 persons (59.5%) in the case group and 4 persons in the control group (10.8%) (P=0.000). Only xerosis was significantly associated with HAM/TSP. Skin manifestations were quite frequent in patients with HAM/TSP. Xerosis was significantly associated with HAM/TSP.

Proietti FA, Carneiro-Proietti AB, Catalan-Soares BC, Murphy EL. Global epidemiology of HTLV-I infection and associated diseases. Oncogene 2005;24:6058-68.

Matsuoka M. Human T-cell leukemia virus type I and adult T-cell leukemia. Oncogene 2003;22:5131-40.

LaGrenade L, Hanchard B, Fletcher V, Cranston B, Blattner W. Infective dermatitis of Jamaican children: a marker for HTLV-I infection. Lancet 1990;336:1345-7.

Lenzi ME, Cuzzi-Maya T, Oliveira AL, Andrada-Serpa MJ, Araújo AQ. Dermatological findings of human T lymphotropic virus type 1 (HTLV-I)-associated myelopathy/tropical spastic paraparesis. Clin Infect Dis 2003;36:507-13.

Blas M, Bravo F, Castillo W, et al. Norwegian scabies in Peru: the impact of human T cell lymphotropic virus type I infection. Am J Trop Med Hyg 2005;72:855-7.

Tokura Y, Sawada Y, Shimauchi T. Skin manifestations of adult T-cell leukemia/lymphoma: clinical, cytological and immunological features. J Dermatol 2014;41:19-25.

Rafatpanah H, Hedayati-Moghaddam MR, Fathimoghadam F, Bidkhori HR, Shamsian SK, Ahmadi S, et al. High prevalence of HTLV-I infection in Mashhad, Northeast Iran: a population-based seroepidemiology survey. J Clin Virol 2011;52:172-6.

Matsuzaki T, Nakagawa M, Nagai M, Usuku K, Higuchi I, Arimura K, et al. HTLV-I proviral load correlates with progression of motor disability in HAM/TSP: analysis of 239 HAM/TSP patients including 64 patients followed up for 10 years. J Neurovirol 2001;7:228-34.

Gonçalves DU, Guedes AC, Proietti AB, Martins ML, Proietti FA, Lambertucci JR, et al. Dermatologic lesions in asymptomatic blood donors seropositive for human T cell lymphotropic virus type-1. Am J Trop Med Hyg 2003;68:562-5.

Hanchard B. Outcomes of early life exposure to human T cell lymphotropic virus type 1. Clin Infect Dis 2005;41:542-3.

Okajima R, Oliveira AC, Smid J, Casseb J, Sanches JA Jr. High prevalence of skin disorders among HTLV-1 infected individuals independent of clinical status. PLoS Negl Trop Dis 2013;7:e2546.

Bittencourt AL, de Oliveira Mde F. Cutaneous manifestations associated with HTLV-1 infection. Int J Dermatol 2010;49:1099-110.

Roucoux DF, Wang B, Smith D, Nass CC, Smith J, Hutching ST, et al. A prospective study of sexual transmission of human T lymphotropic virus (HTLV)-I and HTLV-II. J Infect Dis 2005;191:1490-7.

Alamy AH, Menezes FB, Leite AC, Nascimento OM, Araújo AQ. Dysautonomia in human T-cell lymphotrophic virus type I-associated myelopathy/tropical spastic paraparesis. Ann Neurol 2001;50:681-5.

Setoyama M, Kerdel FA, Elgart G, Kanzaki T, Byrnes JJ. Detection of HTLV-1 by polymerase chain reaction in situ hybridization in adult T-cell leukemia/lymphoma. Am J Pathol 1998;152:683-9.

Files
IssueVol 57, No 3 (2019) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/acta.v57i3.1821
Keywords
HTLV-1 HTLV-1 associated myelopathy (HAM) Tropical spastic paraparesis (TSP) Skin lesions
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Boostani R, Layegh P, Yazdanpanah MJ, Vosoughi E, Mohammadi A, Joneidi N, Bazargani R, Sayadpour Zanjani D, Ebrahimzadeh S. Dermatologic Manifestations in HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis. Acta Med Iran. 2019;57(3):180-183.