Viruses cutaneous infections

Cidofovir (Fig. 2) has been formally approved for the treatment of CMV retinitis in AIDS patients, where it is administered intravenously at a dose not exceeding 5 mg/kg once weekly during the first two weeks (and every other week thereafter). Cidofovir is also used off label for the treatment of human papilloma virus (HPV) infections (i.e., cutaneous warts, anogenital warts, laryngeal and pharyngeal papilloma), polyomavirus [i.e., progressive (i.e., multifocal leukoencephalopathy (PML)], adenovirus, herpesvirus, and poxvirus (i.e., molluscum contagiosum) infections, where it can be administered intravenously (at a dose of < 5 mg/kg once weekly or every other week) or topically as a 1% gel or cream (De Clercq and Holy 2005). Especially in immunosuppressed patients (i.e., transplant recipients), local treatment of HPV-associated lesions has often yielded spectacular results (Bonatti etal.2007). 

The specific antiviral agents used to treat cutaneous infections caused by herpes simplex and varicella zoster viruses are discussed in Chapter 50. 

Infants with SCID have profound immunodehciency and present with frequent episodes of diarrhea, pneumonia, otitis, sepsis, and cutaneous infections. Persistent infections with opportunistic organisms such as Pneumocystis carinii, Epstein-Barr virus, Candida albicans, cytomegalovirus, parainhuenzae 3 virus, respiratory syncitial virus, adenovirus, varicella, and bacille Calmette-Guerin (BCG) lead to death within the hrst or second year of life. ADA dehciency also occurs in adults, but with a much later onset and nhlder, but clinically discernible, immunodehciency [3,5]. 

Andoh T, Shiraki K, Kurokawa M, Kuraishi Y 1995 Paresthesia induced by cutaneous infection with herpes simplex virus in rats. Neurosci Lett 190 101—104... 

Initial and recurrent mucosal and cutaneous herpes simplex virus (HSV) 1 and 2 infections in... 

In response to danger signals, a significant number of both mDC and pDC precursors appear de novo into the circulation (5,13). However, their migration pathways are flexible and are largely dependent on tissue microenvironments. In a cutaneous herpes simplex virus (HSV)-l infection model, newly appeared... 

Neonatal herpes simplex virus infection Treatment of neonatal herpes infections. Parenteral Treatment of initial and recurrent mucosal and cutaneous herpes simplex virus (HSV)-I and -2 and varicella-zoster virus (VZV/shingles) infections in immunocompromised patients. 

Topical acyclovir (Zovirax) is available as a 5% ointment for application to primary cutaneous herpes simplex infections and to limited mucocutaneous herpes simplex virus infections in immunocompromised patients. In primary infections, the use of topical acyclovir shortens the duration of viral shedding and may decrease healing time. In localized, limited mucocutaneous infections in immunocompromised patients, its use may be associated with a decrease in the duration of viral shedding. 

Arikan S, Uzun O, CetinkayaY, Kocagoz S, Akova M, Unal S Primary cutaneous aspergillosis in human immunodeficiency virus-infected patients Two cases and review. Clin Infect Dis 1998 27 641-643. 

Dan, M., Yaniv, R. Cholestatic hepatitis, cutaneous vasculitis, and vascular deposits of immunoglobulin M and complement associated with hepatitis A virus infection. Amer. J. Med. 1990 89 103-104... 

Kindt TJ, Said WA, Bowers FS, Mahana W, Zhao TM, Simpson RM (2000) Passage of human T-cell leukemia virus type-1 during progression to cutaneous T-cell lymphoma results in myelopathic disease in an HTLV-1 infection model. Microbes Infect 2 1139-1146. 

Simpson RM, Leno M, Hubbard BS, Kindt TJ (1996) Cutaneous manifestations of human T cell leukemia virus type I infection in an experimental model. J Infect Dis 173 722-726. 

Of all transplant-related lymphomas 15% are of T cell origin and are unrelated to Epstein-Barr virus infection. Cutaneous T cell lymphomas are rare and carry a good prognosis, with a 90%, 4-year survival rate. Regression is often observed when immunosuppression is withdrawn or reduced. 

Cogrel O, Doutre MS, Marliere V, Beylot-Barry M, Couzigou P, Beylot C. Cutaneous sarcoidosis during interferon alfa and ribavirin treatment of hepatitis C virus infection two cases. Br J Dermatol 2002 146(2) 320-4. 

Variola, the virus that causes smallpox, is a DNA virus. Like several similar viruses, monkeypox, vaccinia and cowpox, variola is a member of the genus Orthopoxvirus. Although all of these viruses can cause infections and cutaneous... 

While the natural history of cutaneous HPV infections is for spontaneous regression within a few months or years, treatments (via medical personnel or the consumer) are frequently used to avoid potential viral spreading, wart enlargement, and individual social discomfort. Home remedies include the use of a pumice stone to remove the callus and/or warm water soaks (forty-five degrees centigrade) for thirty minutes daily for approximately six weeks. Most over-the-counter wart treatments function by chemically destroying the epidermis in which the virus is present and are recommended for the removal of only cutaneous common warts... 

Parenteral acyclovir (e.g., 5 mg/kg infused at a constant rate over 1 hour every 8 hours for 7 days) may be used in mucosal and cutaneous herpes simplex virus infections, and in varicella zoster infections (shingles) in immunocompromised patients and in herpes simplex encephalitis. 

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