Loading...
Publication
Moluscos Contagiosos Exuberantes em Síndrome de Reconstituição Imunológica
Advisor(s)
Abstract(s)
O Síndrome de Reconstituição Imunológica (SRI) é uma entidade descrita recentemente na qual doentes
seropositivos para o VIH com imunodepressão grave e após iniciarem Terapêutica Antiretroviral (TAR), desenvolvem reacções inflamatórias associadas a diferentes agentes patogénicos.
Foram já reportados casos de SRI associados a vários agentes infecciosos como M. Avium Complex, Mycobacterium Tuberculosis e Pneumocystis jirovecci. As manifestações cutâneas no SRI são comuns tendo já sido descritos casos de Herpes Zoster, Doença de Hansen, Sarcoma de Kaposi, Sarcoidose e Granulomas de corpo estranho.
Descreve-se o caso de um doente com numerosos e exuberantes Moluscos Contagiosos na face, pescoço e área genital que surgiram pouco tempo após o início da TAR coincidindo com o aumento na contagem de CD4 e diminuição da carga viral. Com a progressão da reconstituição imunológica as lesões resolveram espontaneamente.
Presume-se que os Moluscos Contagiosos sejam lesões comuns no contexto do SRI mas pouco reportadas.
Apresentamos este caso pela sua exuberância clínica e relação bem documentada com a reconstituição imunológica chamando, portanto, a atenção para esta manifestação do SRI.
Immune Reconstitution Inflammatory Syndrome (IRIS) is a recently described entity in which severely immunodepressed HIV patients, after being started on Highly Active antiretroviral Therapy (HAART), develop inflammatory reactions to several pathogens. Many infectious agents have been reported in association with IRIS including M. Avium Complex, Mycobacterium Tuberculosis and Pneumocystis jirovecci. Skin manifestations are also very common and cases of Herpes Zoster, Hansen disease, Kaposi's Sarcoma, Sarcoidosis and Foreign body granulomas have been described. We present a patient who developed extensive and countless Molluscum Contagiosum lesions on his neck, face and genitals, shortly after being started on HAART which induced an increase in his CD4 cell count and decrease in viral load. With the progression of immunoreconstitution, the lesions healed spontaneously. Molluscum Contagiosum lesions are presumably commonly associated with IRIS but underreported. We point out this case for its exuberant clinical picture and well-documented relation to immunoreconstitution thus drawing attention to this IRIS manifestation.
Immune Reconstitution Inflammatory Syndrome (IRIS) is a recently described entity in which severely immunodepressed HIV patients, after being started on Highly Active antiretroviral Therapy (HAART), develop inflammatory reactions to several pathogens. Many infectious agents have been reported in association with IRIS including M. Avium Complex, Mycobacterium Tuberculosis and Pneumocystis jirovecci. Skin manifestations are also very common and cases of Herpes Zoster, Hansen disease, Kaposi's Sarcoma, Sarcoidosis and Foreign body granulomas have been described. We present a patient who developed extensive and countless Molluscum Contagiosum lesions on his neck, face and genitals, shortly after being started on HAART which induced an increase in his CD4 cell count and decrease in viral load. With the progression of immunoreconstitution, the lesions healed spontaneously. Molluscum Contagiosum lesions are presumably commonly associated with IRIS but underreported. We point out this case for its exuberant clinical picture and well-documented relation to immunoreconstitution thus drawing attention to this IRIS manifestation.
Description
Keywords
HCC DER HCC INF HIV Síndrome Inflamatória da Reconstituição Imune Molusco Contagioso
Citation
Revista SPDV 2006;64(3):399-402
Publisher
Sociedade Portuguesa de Dermatologia e Venereologia