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Cutaneous infections by papillomavirus, herpes zoster and Candida albicans as the only manifestation of idiopathic CD4+ T lymphocytopenia

1999; Wiley; Volume: 38; Issue: 2 Linguagem: Inglês

10.1046/j.1365-4362.1999.00364.x

1365-4632

Pilar Manchado Lopez, Jose M. G. Ruiz De Morales, Inmaculada Ruíz González, Manuel Ángel Rodríguez Prieto,

Herpesvirus Infections and Treatments

Abstract Background Selective depletion of CD4+ T lymphocytes is common in both primary and secondary immunodeficiencies. Idiopathic CD4+ T lymphocytopenia (ICL) cases are defined as a persistent CD4+ T lymphocyte count of less than 300×10 6 cells/L and/or less than 20% of the total T‐cell count. Method A 40‐year‐old woman, with a history of psoriasis and paracetamol allergy, presented with persistent warts of the hands and condylomas of the ano‐genitalia. Histological and virological analysis was carried out on genital and cutaneous lesions and peripheral blood. Results Serology for HIV‐1, HIV‐2, Epstein–Barr virus and parvovirus B19 were negative. There was lymphopenia of 10% CD4+ cells, with normal numbers of total leukocytes; there were no other abnormal immunological findings. DNA analysis of cutaneous lesions revealed HPV‐49 and HPV‐3 in the hands and HPV‐6 in the genital region. Conclusions The cause of the ICL in this patient is unknown. HPV is not known to be an immunosuppressive agent; it remains to be determined whether the HPV‐associated lesions are the cause or the result of immunosuppression.