Abstract | BACKGROUND: Patients with stem cell transplantation (SCT) develop erythematous eruptions (SCTE) that are often misdiagnosed and poorly treated. Latent herpes simplex virus (HSV) is likely to be reactivated by SCT-associated immunosuppression. Therefore, one of the differential diagnostic possibilities for SCTE is HSV-associated erythema multiforme ( HAEM) in which HSV genetic fragments localize in stem cells that deliver them to the skin on differentiation. OBSERVATIONS: CONCLUSIONS: There is a growing problem with SCTE, related to the increasing numbers of performed SCT. The greater frequency of SCT-generated circulating stem cells in patients with hematological malignant neoplasms (who have latent HSV infection) may result in a widespread SCTE characterized by skin deposition of HSV DNA fragments, notably those expressing Pol antigen. This HAEM-like presentation should be considered in the differential diagnosis of SCTE. Prolonged high-dosage antiviral chemotherapy during and after hospitalization may be warranted.
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Authors | Joseph W Burnett, Jennifer M Laing, Laure Aurelian |
Journal | Archives of dermatology
(Arch Dermatol)
Vol. 144
Issue 7
Pg. 902-7
(Jul 2008)
ISSN: 1538-3652 [Electronic] United States |
PMID | 18645142
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Antigens, CD34
- DNA, Viral
- Viral Proteins
- DNA-Directed DNA Polymerase
- Exodeoxyribonucleases
- DNA polymerase, Simplexvirus
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Topics |
- Acute Disease
- Adult
- Antigens, CD34
(analysis)
- DNA, Viral
(analysis)
- DNA-Directed DNA Polymerase
(genetics)
- Erythema Multiforme
(etiology, pathology, virology)
- Exodeoxyribonucleases
(genetics)
- Herpes Simplex
(complications)
- Humans
- Simplexvirus
(enzymology, genetics, immunology, isolation & purification)
- Stem Cell Transplantation
- Viral Proteins
(genetics)
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