Mileo Bacelar Guerreiro Flávio, Tavares Sodré Celso, Brandão Pavan Lorena, Feijó Barroso Paulo, Carvalho Quintella Daniele, Cuzzi Tullia, Ramos-E-Silva Marcia
Professor Marcia Ramos-e-Silva, MD, PhD, Rua Dona Mariana 143 / C-32, Rio de Janeiro 22280-020, Brazil;
Acta Dermatovenerol Croat. 2018 Dec;26(4):333-336.
Strongyloidiasis is a parasitic infestation caused by the helminth Strongyloides stercoralis. It is essentially gastrointestinal and in general asymptomatic but can sometimes present with skin signs. Immunocompromised patients can develop the disseminated form of the disease due to the parasite's opportunistic behavior, as in cases of coinfection by the human T-lymphotropic type 1 virus (HTLV-1). This article presents a case of a patient infected with HTLV-I and Strongyloides stercoralis who developed the disseminated form. There were purpuric reticulated periumbilical lesions as well as vibices on the patient's flanks. Histopathologic exam of a skin lesion revealed the presence of larvae in the deep reticular dermis. We emphasize the relevance of awareness regarding interaction between HTLV-1 and strongyloidiasis, besides identification of the cutaneous manifestations of the disease to reach an appropriate therapeutic diagnosis.
类圆线虫病是由蠕虫粪类圆线虫引起的寄生虫感染。它主要累及胃肠道,通常无症状,但有时可出现皮肤症状。免疫功能低下的患者可能会因寄生虫的机会性感染行为而发展为播散型疾病,例如在人类嗜T淋巴细胞1型病毒(HTLV-1)合并感染的情况下。本文介绍了一例感染HTLV-1和粪类圆线虫的患者发展为播散型疾病的病例。患者脐周有紫癜性网状病变,双侧胁腹有瘀斑。皮肤病变的组织病理学检查显示在深层网状真皮中有幼虫存在。我们强调除了识别该疾病的皮肤表现以做出适当的治疗诊断外,认识HTLV-1与类圆线虫病之间相互作用的相关性也很重要。