E. Munoz et al., HERPETIC SYRINGITIS ASSOCIATED WITH ECCRINE SQUAMOUS SYRINGOMETAPLASIA IN HIV-POSITIVE PATIENTS, Journal of cutaneous pathology, 24(7), 1997, pp. 425-428
Herpetic syringitis has been described as a rare manifestation of herp
es virus infection in patients with an immunodeficiency usually second
ary to human immunodeficiency virus (HIV) infection. Eccrine squamous
syringometaplasia (ESS) is an infrequent alteration of the eccrine duc
t epithelium reported in association with several conditions, includin
g chronic ulcers, inflammatory processes, and patients receiving chemo
therapy. The association of herpetic syringitis with ESS has not been
reported before. We identified 3 cases of herpetic syringitis associat
ed with ESS in patients with the acquired immunodeficiency syndrome. I
n 2 of 3 cases the signs of herpetic syringitis were limited to the me
taplastic duct epithelium, but in 1 case there were also herpetic alte
rations without ESS. The histological features of herpetic infection i
n HIV-positive patients may be atypical and lack the typical epidermal
alterations, observing only an extensive epidermal necrosis. In those
cases, the alterations of the eccrine ducts may be a diagnostic clue
in the diagnosis of herpetic infection. ESS of the ductal epithelium i
s probably secondary to the herpetic infection, although it might also
stimulate the extension of the herpetic infection. Futher studies are
needed to elucidate the association of ESS and herpes virus infection
. (C) Munksgaard 1997.