Human Herpesvirus-6 cytopathic inclusions: an exceptional and recognizable finding on skin biopsy during HHV6 reactivation after autologous stem-cell transplantation

The American Journal of Dermatopathology
Jennifer RouxAnne Janin

Abstract

Skin rash are common in immunocompromised patients, particularly after bone marrow transplantation. Human herpes virus 6 (HHV6) reactivation is often suspected, but its clinical presentation and the routine laboratory tests may be unspecific, thus leading to late diagnosis. In this case, we report specific intralymphocytic cytopathic inclusions on skin biopsy as a sign of systemic HHV6 reactivation. A 56-year-old patient presented progressive erythroderma and fever occurring after autologous hematopoietic stem-cell transplantation for mantle cell lymphoma. The skin biopsy showed a perivascular infiltrate of medium-to-large lymphocytes with irregular nuclei containing a large central basophilic inclusion surrounded by a clear halo. High levels of HHV-6 genomic in skin biopsy confirm HHV-6-induced cytopathic effect. The clinical course improved with intravenous foscavir. The specific histopathological findings encountered in this case are exceptional but recognizable, and along with HHV-6 DNA detection allow a prompt recognition of HHV6 skin rash.

References

Oct 21, 2004·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Irina MaricStefania Pittaluga
Jan 18, 2005·Clinical Microbiology Reviews·Leen De BolleErik De Clercq
Jun 16, 2009·Journal of Cutaneous Pathology·Anjela GalanRossitza Lazova
Jul 26, 2011·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Henri Agut

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Citations

Jan 10, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P BonnafousC Gaudy-Graffin

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