Chronic verrucous varicella-zoster virus infection in patients with the acquired immunodeficiency syndrome (AIDS): Histologic and molecular biologic findings

P. E. LeBoit, M. Limova, T. S B Yen, J. M. Palefsky, Clifton White, T. G. Berger

Research output: Contribution to journalArticle

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Abstract

Verrucous skin lesions have been attributed to various herpes viruses in immunosuppressed patients, including those with human immunodeficiency virus infection (HIV). We examined such lesions from six HIV-infected patients to determine the range of microscopic findings present and to establish which herpesviruses were present. Verrucous epidermal hyperplasia, pseudocarcinomatous hyperplasia, and massive hyperkeratosis correlate with the warty clinical appearance of the lesions. Herpetic cytopathic changes, including multinucleated epidermal giant cells, steel-gray nuclei, necrotic acantholytic keratinocytes, and Cowdry type A nuclear inclusions were seen most prominently in the dells between papillations and in adnexal epithelium. In two cases, increased numbers of spindled cells were seen in the dermis. Immunoperoxidase staining with anti-type IV collagen antibodies demonstrated that these findings were not those of Kaposi's sarcoma, but represent a fibrotic reaction to the infection. Viral cultures of four of the cases demonstrated the presence of varicella-zoster virus, whose presence was detected by the polymerase chain reaction in paraffin-embedded lesional tissue from all six cases. Polymerase chain reaction did not show the presence of cytomegalovirus, herpes simplex, Epstein-Barr, or human papillomavirus. We conclude that these unusual verrucous lesions are a chronic manifestation of herpes zoster infection and that the reported presence of other agents in such lesions is probably coincidental.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAmerican Journal of Dermatopathology
Volume14
Issue number1
StatePublished - 1992
Externally publishedYes

Fingerprint

Human Herpesvirus 3
Virus Diseases
Hyperplasia
Acquired Immunodeficiency Syndrome
HIV
Intranuclear Inclusion Bodies
Polymerase Chain Reaction
Herpes Simplex
Collagen Type IV
Kaposi's Sarcoma
Herpesviridae
Steel
Herpes Zoster
Giant Cells
Dermis
Infection
Cytomegalovirus
Keratinocytes
Paraffin
Epithelium

Keywords

  • Cytomegalovirus
  • Herpes simplex virus
  • Polymerase chain reaction
  • Pseudocarcinomatous hyperplasia
  • Varicella
  • Verruca
  • zoster virus

ASJC Scopus subject areas

  • Dermatology
  • Pathology and Forensic Medicine

Cite this

Chronic verrucous varicella-zoster virus infection in patients with the acquired immunodeficiency syndrome (AIDS) : Histologic and molecular biologic findings. / LeBoit, P. E.; Limova, M.; Yen, T. S B; Palefsky, J. M.; White, Clifton; Berger, T. G.

In: American Journal of Dermatopathology, Vol. 14, No. 1, 1992, p. 1-7.

Research output: Contribution to journalArticle

LeBoit, P. E. ; Limova, M. ; Yen, T. S B ; Palefsky, J. M. ; White, Clifton ; Berger, T. G. / Chronic verrucous varicella-zoster virus infection in patients with the acquired immunodeficiency syndrome (AIDS) : Histologic and molecular biologic findings. In: American Journal of Dermatopathology. 1992 ; Vol. 14, No. 1. pp. 1-7.
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