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Superficial Thrombophlebitis: A New Clinical Manifestation of the Immune Reconstitution Inflammatory Syndrome in a Patient With HIV Infection

Alcaraz, Inmaculada MD*; Revelles, Juan Maria MD*; Camacho, Diana MD*; Haro, Rosario MD*; Fernández-Aceñero, María Jesús MD†; Fernández-Guerrero, Manuel MD‡; Requena, Luis MD*

American Journal of Dermatopathology: December 2010 - Volume 32 - Issue 8 - pp 846-849
doi: 10.1097/DAD.0b013e3181d88d2e
Extraordinary Case Report

Skin manifestations of immune reconstitution inflammatory syndrome in response to highly active antiretroviral therapy may account for up to 50% of the clinical presentations in this syndrome. Viable or dying infective antigens, host antigens, tumoral antigens, and others may target immune reconstitution inflammatory syndrome, resulting in a wide spectrum of clinical manifestations. We describe a 26-year-old HIV-infected man who had started highly active antiretroviral therapy a few months earlier. He developed multiple linear nodules following the superficial veins in both legs. Histopathologic examination demonstrated a mostly septal panniculitis with features of superficial thrombophlebitis. We propose that superficial thrombophlebitis should be added to the list of clinical manifestations of this newly observed immune restoration disease.

From the *Department of Dermatology; †Department of Pathology; and ‡Department of Infectious Diseases, Fundación Jimenez Díaz, Universidad Autónoma, Madrid, Spain.

Reprints: Inmaculada Alcaraz, MD, Department of Dermatology, Avda. Reyes Católicos 2, Fundación Jiménez Díaz, 28040-Madrid, Spain (e-mail: ialcarazl@fjd.es).

© 2010 Lippincott Williams & Wilkins, Inc.