Granulomatous reaction as a postherpetic isotopic response after primary varicella infection in a healthy adult

IF 1.1 Q4 ALLERGY
Tomoki Niimura MD, Yuko Watanabe MD, PhD, Michiko Aihara MD, PhD, Yukie Yamaguchi MD, PhD
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Abstract

We report the first case of post-herpetic isotopic reaction (PHIR) after primary varicella infection in a healthy adult. PHIR refers to the development of new skin lesions at sites where prior herpetic skin lesions have been resolved. Herpes zoster is the most common cause of PHIR; however, only a few cases of PHIR due to primary varicella infections have been reported.

Abstract Image

健康成人原发性水痘感染后作为疱疹后同位素反应的肉芽肿反应
疱疹后同位素反应是Wolf同位素反应(WIR)的一种,一些人认为WIR是Koebner反应。1然而,Koebner反应通常表明受伤皮肤上出现了相同的预先存在的皮肤病。在本例中,原发性皮疹后出现了完全不同的皮疹。因此,将其描述为PHIR是恰当的。PHIR有多种皮肤表现,其中肉芽肿性皮炎最为常见。根据王等人的研究,作为PHIR的肉芽肿性反应的发病机制可能包括感染后的神经损伤和残留的病毒颗粒,它们可能诱导白细胞介素-4和其他趋化因子的分泌,促进炎症细胞的浸润,并局部调节免疫和血管生成反应。2与HZ相关的神经损伤相比,原发性水痘相关的神经损害较小,这可能是原发性静脉曲张感染后罕见PHIR现象的原因。先前报道过几例原发性水痘后作为PHIR的肉芽肿性反应的儿科病例。3-6先前报道了两例成人PHIR病例,但这些患者是免疫抑制的骨髓性白血病宿主。免疫受损的患者容易受到VZV更大的神经损伤。7这是第一例健康成人水痘感染后的PHIR病例。组织学研究结果支持了对残留病毒颗粒产生超免疫反应的可能性,从而导致肉芽肿性皮炎。血液样本显示免疫球蛋白水平略低,但未观察到其他异常。尽管病因尚不清楚,但应仔细随访患者,以了解免疫系统疾病的未来发展。需要进一步的研究来了解水痘感染后PHIR的潜在机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.60
自引率
10.00%
发文量
69
审稿时长
12 weeks
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