Human T-cell lymphotropic virus 1 (HTLV-1) infection can lead to myelopathy/tropical spastic paresis and adult T-cell leukemia/lymphoma (ATLL). Infection with HTLV-1 has also been associated with clinically significant immunosuppression. Crusted scabies, also known as Norwegian scabies, is an uncommon presentation of scabies that may occur in conjunction with immunosuppression. Although crusted scabies has been reported in association with HTLV-1 infection, to our knowledge it has never been described in association with HTLV-1 associated myelopathy.
Objective:
The aim is to describe a case of HTLV-1 associated myelopathy and concomitant crusted scabies.
Methods:
This article includes a case report and a literature review.
Conclusions:
Crusted scabies is reported in association with HTLV-1 infection with or without concomitant ATLL. Crusted scabies should be considered in the differential diagnosis of a generalized cutaneous eruption in an HTLV-1 positive patient. Patients with crusted scabies from an HTLV-1 endemic population should be tested for a possible HTLV-1 infection. These patients may be at increased risk of progressing to ATLL.
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References
1.
WilliamsAEFangCTSlamonDJ. Seroprevalence and epidemiological correlates of HTLV-I infection in U.S. blood donors. Science1988; 240:643–646.
2.
OgerJJWerkerDHFotiDJ. HTLV-I associated myelopathy: An endemic disease of Canadian Aboriginals of the Northwest Pacific coast?Can J Neurol Sci1993; 20:302–306.
3.
PicardFJCoulthartMBOgerJ. Human T-lymphotropic virus type 1 in coastal natives of British Columbia: Phylogenetic affinities and possible origins. J Virol1995; 69:7248–7256.
4.
WhittakerSJNgYLRustinM. HTLV-1-associated cutaneous disease: A clinicopathological and molecular study of patients from the U.K.Br J Dermatol1993; 128:483–492.
5.
UchiyamaT. Human T cell leukemia virus type I (HTLV-I) and human diseases. Annu Rev Immunol1997; 15:15–37.
6.
DiCaudoDJPerniciaroCWorrellJT. Clinical and histologic spectrum of human T-cell lymphotropic virus type-1 associated lymphoma involving the skin. J Am Acad Dermatol1996; 34:69–76.
7.
SharataHHColvinJHFujiwaraK. Cutaneous and neurologic disease associated with HTLV-1 infection. J Am Acad Dermatol1997; 36:869–871.
8.
YasuiCFukayaTKoizumiH. HTLV-1 -associated myelopathy in a patient with adult T-cell leukemia. J Am Acad Dermatol1991; 24:633–637.
9.
NakadaKKohakuraMKomodaH. High incidence of HTLV antibody in carriers of Strongyloides stercoralis. Lancet1984; i:633.
10.
HanadaSUematsuTIwahashiM. The prevalence of human T-cell leukemia virus type 1 in patients with hematologic and non-hematologic diseases in an adult T-cell leukemia-endemic area of Japan. Cancer1989; 64:1290–1295.
11.
MarshBJ. Infectious complications of human T cell leukemia/lymphoma virus type I infection. Clin Infect Dis1996; 23:138–145.
12.
TachibanNOkayamaAIshizakiJ. Suppression of tuberculin skin reaction in healthy HTLV-1 carriers from Japan. Int J Cancer1988; 42:829–831.
13.
WellesSLTachibanaNOkayamaA. Decreased reactivity to PPD among HTLV-I carriers in relation to virus and hematologic status. Int J Cancer1994; 56:337–340.
14.
KashalaOMarlinkRIlungaM. Infection with human immunodeficiency virus type 1 (HIV) and human T cell lymphotropic viruses among leprosy patients and contacts: Correlation between HIV-1 cross-reactivity and antibodies to lipoarabinomannan. J Infect Disease1994; 169:296–304.
15.
VerdierMDenisFSangareA. Antibodies to human T lymphotropic virus type 1 in patients with leprosy in tropical areas. J Infect Dis1990; 161:1309–1310.
16.
MollisonLCLoSTMarningG. HTLV-I and scabies in Australian aborigines (Letter). Lancet1993; 341:1281–1282.
17.
MollisonLC. HTLV-I and clinical disease correlates in central Australian aborigines (Letter). Med J Aust1994; 160:238.
18.
IkedaSMomitaSKinoshitaK. Clinical course of human T-lymphotropic virus type 1 carriers with molecularly detectable monoclonal proliferation of T lymphocytes: Defining a low- and high-risk population. Blood1993; 82:2017–2024.
19.
La GrenadeL. HTLV-I-associated infective dermatitis: Past, present, and future. J Acquir Immune Defic Syndr Hum Retrovirol1996; 13:46S–49S.
20.
GretenTFSlanskyJEKubotaR. Direct visualization of antigen-specific T cells: HTLV-1 Tax11-19-specific CD8(+) T cells are activated in peripheral blood and accumulate in cerebrospinal fluid from HAM/TSP patients. Proc Natl Acad Sci U S A1998; 95:7568–7573.
21.
KubotaRKawanishiTMatsubaraH. Demonstration of human T lymphotropic virus type I (HTLV-I) tax-specific CD8+ lymphocytes directly in peripheral blood of HTLV-1-associated myelopathy/tropical spastic paraparesis patients by intracellular cytokine detection. J Immunol1998; 161:482–488.
22.
ParishLCLomholtG. Crusted scabies: Alias Norwegian scabies. Intl J Dermatol1976:15:747–748.
ArlianLGRappCMMorganMS. Resistance and immune response in scabies-infested hosts immunized with Dermatophagoides mites. Am J Trop Med Hyg1995; 52:539–545.
26.
MosmannTRSadS. The expanding universe of T-cell subsets: Th1, Th2 and more. Immunol Today1996; 17:138–146.
27.
Jaramillo-AyerbeFBerrio-MunozJ. Ivermectin for crusted Norwegian scabies induced by use of topical steroids. Arch Dermatol1998; 134:143–145.
DeKruyffRHFangYUmetsuDT. Corticosteroids enhance the capacity of macrophages to induce Th2 cytokine synthesis in CD4+ lymphocytes by inhibiting IL-12 production. J Immunol1998; 160:2231–2237.
EgawaKJohnoMHayashibaraT. Familial occurrence of crusted (Norwegian) scabies with adult T-cell leukaemia. Br J Dermatol1992; 127:57–59.
32.
DaisleyHCharlesWSuiteM. Crusted (Norwegian) scabies as a pre-diagnostic indicator for HTLV-1 infection. Trans R Soc Trop Med Hyg1993; 87:295.
33.
CordolianiFVasseurEBaccardM. Ivermectin-responsive crusted scabies in HTLV1 carrier. Dermatology1996; 192: 351–352.
34.
del GiudiceP. Scabies in HTLV-I seropositive patients (Letter>; comment). J Am Acad Dermatol1997; 36:134–135.
35.
del GiudicePMarieD SainteGerardY. Is crusted (Norwegian) scabies a marker of adult T cell leukemia/lymphoma in human T lymphotropic virus type 1-seropositive patients?J Infect Dis1997; 176:1090–1092.
36.
DePaoliRTMarksVJ. Crusted (Norwegian) scabies: Treatment of nail involvement. J Am Acad Dermatol1987; 17:136–139.
