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

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  • 1 Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy;
  • | 2 Unit of Infectious Diseases, Department of Medical Sciences, University of Turin at the Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy;
  • | 3 Division of Haematology, Department of Oncology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy;
  • | 4 Department of Oncology, Pathology Unit, University of Turin, Turin, Italy

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.

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