HERPETIC SYRINGITIS ASSOCIATED WITH ECCRINE SQUAMOUS SYRINGOMETAPLASIA IN HIV-POSITIVE PATIENTS

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.