FOLLICULITIS DECALVANS AND HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE I-ASSOCIATED MYELOPATHY TROPICAL SPASTIC PARAPARESIS/

Human T-cell lymphotropic virus type I (HTLV-I) can be associated with either adult T-cell leukemia or HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic progressive immune-mediated myelopathy. Skin manifestations such as xerosis and erythema may be as sociated with HAM/TSP. Infective dermatitis due to Staphylococcus aure us or beta-hemolytic Streptococcus has recently been described as a ma rker for HTLV-I infection and as a probable risk factor for the develo pment of adult T-cell leukemia and lymphoma in Jamaican children. We r eport a case of folliculitis decalvans, a rare chronic follicular infl ammatory process of bacterial origin that is extremely resistant to tr eatment, in a patient with HAM/TSP. This case suggests the possibility that the disturbance of the immune system that was observed in patien ts with HAM/TSP can play a role in the persistence of this severe skin lesion. In addition, the findings of our case cast doubt on the hypot hesis that the cause of infective dermatitis in persons infected with HTLV-I is immunosuppression due to congenital or perinatal infection o f the immature immune system.