Article Category:
Case Report

Case Report: Atypical Cutaneous Presentation of Human T-cell Lymphotropic Virus Type 1-Related Adult T-cell Lymphoma

Gianluca Avallone Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Mattia Trunfio Unit of Infectious Diseases, Department of Medical Sciences, University of Turin at the Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy;

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Luca Mastorino Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Andrea Agostini Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Martina Merli Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Marco Rubatto Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Daniele Caracciolo Division of Haematology, Department of Oncology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy;

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Andrea Calcagno Unit of Infectious Diseases, Department of Medical Sciences, University of Turin at the Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy;

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Rebecca Senetta Department of Oncology, Pathology Unit, University of Turin, Turin, Italy

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Maria Teresa Fierro Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Pietro Quaglino Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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Simone Ribero Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;

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DOI:
https://doi.org/10.4269/ajtmh.21-0630
Volume/Issue:
Volume 105: Issue 6
Page(s):
1590–1593
Restricted access
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ABSTRACT.

Human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus endemic in many parts of the world. Because of migration, cases of HTLV-1 in non-HTLV-1 endemic countries have been increasingly reported. Clinical presentation of HTLV-1 infection is highly variable, with a significant risk of diagnostic delays. Skin can be the first site affected by HTLV-1-related manifestations such as cutaneous involvement of adult T-cell leukemia/lymphoma (ATLL) and infective dermatitis associated with HTLV-1. A 32-year-old Nigerian man was admitted to the infectious disease department for high fever, asthenia, lymphocytosis, and vesicular bullous lesions on both hand palms and lower limbs. After clinical work-up was performed, bacterial superinfected herpes simplex viurs-2 ulcers were the presenting sign of HTLV-1-related chronic type ATLL. Standard treatment based on interferon-α plus zidovudine was started, but it was poorly tolerated; therefore, switching to an off-label dual antiretroviral regimen was attempted. The increasing prevalence of HTLV-1 in nonendemic areas may enhance the development of alternative treatments with better efficacy and tolerability profiles.

Author Notes

Address correspondence to Gianluca Avallone, Section of Dermatology, Department of Medical Sciences, University of Turin, Via Cherasco 23, 10121, Turin, Italy. E-mail: gianluca.avallone2@gmail.com

These authors contributed equally to this article and share first authorship. ‡These authors contributed equally to this article and share senior authorship.

Authors’ addresses: Gianluca Avallone, Luca Mastorino, Andrea Agostini, Martina Merli, Marco Rubatto, Maria Teresa Fierro, Pietro Quaglino, and Simone Ribero, Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy, E-mails: gianluca.avallone2@gmail.com, lucamastorino02@gmail.com, andrea93.agostini@gmail.com, martinamerli93@gmail.com, rubattomarco@gmail.com, pietro.quaglino@unito.it, mariateresa.fierro@unito.it, and simone.ribero@unito.it. Mattia Trunfio and Andrea Calcagno, Unit of Infectious Diseases, Department of Medical Sciences, University of Turin at the “Amedeo di Savoia” Hospital, ASL “Città di Torino”, Turin, Italy, E-mails: mattia.trunfio@edu.unito.it and andrea.calcagno@unito.it. Daniele Caracciolo, Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy, E-mail: dcaracciolo@cittadellasalute.to.it. Rebecca Senetta, Department of Oncology, Pathology Unit, University of Turin, Turin, Italy, E-mail: rebesenetta@gmail.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2021
Received:
06 Jun 2021
|
Accepted:
04 Aug 2021
|
Published Online:
11 Oct 2021
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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