Skip Navigation LinksHome > August 2012 - Volume 34 - Issue 6 > Human Herpesvirus-6 Cytopathic Inclusions: An Exceptional a...
American Journal of Dermatopathology:
doi: 10.1097/DAD.0b013e31825667ed
Extraordinary Case Report

Human Herpesvirus-6 Cytopathic Inclusions: An Exceptional and Recognizable Finding on Skin Biopsy During HHV6 Reactivation After Autologous Stem-Cell Transplantation

Roux, Jennifer MD*; Battistella, Maxime MD*,†,‡; Fornecker, Luc MD†,§; LeGoff, Jérôme PharmD, PhD¶,‖; Deau, Bénédicte MD†,§; Houhou, Nadira PharmD, PhD#; Bouaziz, Jean-David MD, PhD†,**; Thieblemont, Catherine MD, PhD†,‡,‖; Janin, Anne MD, PhD*,†,‡

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Abstract

Abstract: Skin rash are common in immunocompromised patients, particularly after bone marrow transplantation. Human herpes virus 6 (HHV6) reactivation is often suspected, but its clinical presentation and the routine laboratory tests may be unspecific, thus leading to late diagnosis. In this case, we report specific intralymphocytic cytopathic inclusions on skin biopsy as a sign of systemic HHV6 reactivation. A 56-year-old patient presented progressive erythroderma and fever occurring after autologous hematopoietic stem-cell transplantation for mantle cell lymphoma. The skin biopsy showed a perivascular infiltrate of medium-to-large lymphocytes with irregular nuclei containing a large central basophilic inclusion surrounded by a clear halo. High levels of HHV-6 genomic in skin biopsy confirm HHV-6–induced cytopathic effect. The clinical course improved with intravenous foscavir. The specific histopathological findings encountered in this case are exceptional but recognizable, and along with HHV-6 DNA detection allow a prompt recognition of HHV6 skin rash.

© 2012 Lippincott Williams & Wilkins, Inc.

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