Human T-Cell Lymphotropic Virus Type-1 (HTLV-1) Infection in Dermatology

  • Achiléa Lisboa BittencourtEmail author


Initially, we did a review about the human T-cell lymphotropic virus type-1 (HTLV-1) considering its prevalence, means of transmission, pathogenicity and diagnosis of its infection. Only the HTLV-1-related diseases of dermatological interest are described more extensively, such as infective dermatitis-associated with HTLV-1 (IDH) and adult T-cell leukemia/lymphoma (ATL), diseases occurring in vertically infected carriers. IDH is a severe chronic eczema occurring in childhood and rarely in adults. Progression of IDH to HTLV-1-associated myelopathy and ATL has been reported. ATL is a T-cell leukemia/lymphoma directly related to HTLV-1 that frequently affects the skin as a primary or secondary condition. It has been classified into five types, namely acute, chronic, lymphoma, smoldering and primary cutaneous tumoral (PCT). This classification is essential for treatment decisions and evaluation of prognosis.


Human T-cell lymphotropic virus type 1 infection Vertical transmission Crusted scabies Acquired ichthyosis Infective dermatitis associated with HTLV-1 HTLV-1-associated myelopathy/tropical spastic paraparesis Adult T-cell leukemia/lymphoma Primary cutaneous lymphomas Primary cutaneous adult T-cell leukemia/lymphoma Mycosis fungoides 




Epidermal hyperplasia (thickening of the epidermis). It implies increased thickness of the (stratum spinosum).

Anaplastic nuclei 

Refers to a group of changes in a cell, loss of polarity (cells may not develop connections to one another), pleomorphism (cells vary in size and shape; their nuclei may also vary in size and shape), hyperchromatism (the nuclei of malignant cells often stain darker than normal cells), abnormal mitoses (division of malignant cells often is abnormal, a feature recognized by “abnormal mitotic figures”) that point to a possible malignant transformation.

Clonal proliferation 

In HTLV-1 infection, is the process in which expansion of infected T cells occur by mitosis. When the proliferation is clonal, the generated cells are identical and all of them have the HTLV-1 provirus integrated in the same site in the host genome. The population of identical infected cells constitutes a clone. Thus, each infected clone can be distinguished from other infected clones by the integration site of the provirus in the host human genome. This process is stimulated by HTLV-1 products.

Crusted scabies 

A rare, highly contagious uncommon form of scabies characterized by presence of huge number of Sarcoptes scabiei in the horny layer of the epidermis. As a reaction, the horny layer thickens and forms warty crusts. In most cases it is associated with some underlying diseases and usually affects immunocompromised patients.


Generalized exfoliative dermatitis. It is a disease characterized by erythema and scaling of greater than 90% of the body’s surface.

Folliculotropism and angiotropism 

The invasion of folicular units and vessel walls by lymphocytes. In malignant conditions the lymphocytes show variable degrees of nuclear atypia.


Thickening of the horny layer of the skin.


It may be inherited (genetic) or acquired during life. The inherited forms are rare, generally present from infancy, and are usually lifelong conditions. Acquired ichthyosis can develop at any age due to a number of medical problems.

Pagetoid infiltration 

Pagetoid is a term used in dermatology to refer to “upward spreading” of abnormal cells in the epidermis (i.e., from bottom to top). It is a possible indication of a precancerous or cancerous condition.


A mode of keratinization characterized by the retention of nuclei in the stratum corneum. Parakeratosis is associated with the thinning or loss of the granular layer and is usually seen in diseases of increased cell turnover.

Pautrier’s microabscess 

One of the well-defined collections of mycosis cells located within the epidermis in T-cell lymphomas mainly in mycosis fungoides. They are atypical lymphocytes clusters in the epidermis with little associated spongiosis.


A condition whereby the nasal cavity is filled with a significant amount of mucus fluid. The condition, commonly known as a runny nose, occurs relatively frequently.


A microscopic term referring to increased intercellular fluid in the epidermis (intercellular edema) that physically pulls keratinocytes away from each other. If severe, spongiosis will cause intraepidermal vesicles (spongiotic vesicles).


Dryness of mucous membranes of the oral cavity and pharynx. It is a consequence of salivary gland dysfunction. Saliva plays an important role in maintaining the correct condition of the oral cavity mucosa.


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Suggestions ReadingIn Portuguese

  1. HTLV-1. LIVRO HEMOMINAS, vol. XVI, 6ª Ed. Belo Horizonte, Fundação HEMOMINAS, 2015. Available from: C:/Users/abittencourt/Downloads/livro_htlv-2015.pdf.Google Scholar
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  5. Bittencourt AL, Oliveira MFSP. Dermatite Infecciosa associada ao HTLV-1- Revisão. An Bras Dermatol. 2001;76:723–32.Google Scholar

In English

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Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  1. 1.Pathology Department, Complexo Hospitalar Universitario Prof. Edgard SantosSalvador BahiaBrazil

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