Cutaneous infections by papillomavirus, herpes zoster and Candida albicansas the only manifestation of idiopathic CD4+T lymphocytopenia

Background Selective depletion of CD4+ T lymphocytes is common in both prim ary and secondary immunodeficiencies. Idiopathic CD4+ T lymphocytopenia (IC L) cases are defined as a persistent CD4+ T lymphocyte count of less than 3 00x10(6) cells/L and/or less than 20% of the total T-cell count. Method A 40-year-old woman, with a history of psoriasis and paracetamol all ergy, presented with persistent warts of the hands and condylomas of the an o-genitalia. Histological and virological analysis was carried out on genit al and cutaneous lesions and peripheral blood. Results Serology for HIV-1, HIV-2, Epstein-Barr virus and parvovirus B19 we re negative. There was lymphopenia of 10% CD4+ cells, with normal numbers o f total leukocytes; there were no other abnormal immunological findings. DN A analysis of cutaneous lesions revealed HPV-49 and HPV-3 in the hands and HPV-6 in the genital region. Conclusions The cause of the ICL in this patient is unknown. HPV is not kno wn to be an immunosuppressive agent; it remains to be determined whether th e HPV-associated lesions are the cause or the result of immunosuppression.