valacyclovir and Hydroa-Vacciniforme

Hydroa vacciniforme is one of the rarest forms of photosensitivity disorders of the skin. Effective treatment options are scarce and mainly constitute of strict sun protection. Lately, hydroa vacciniforme has been associated with Epstein-Barr virus infection. We present a patient with hydroa vacciniforme and concomitant previous/chronic Epstein-Barr virus infection. In this case, antiviral treatment was successful.

Topics: Acyclovir; Antiviral Agents; Child; Chronic Disease; Epstein-Barr Virus Infections; Humans; Hydroa Vacciniforme; Male; Valacyclovir; Valine

A 35-year-old Chinese woman presented with a 2.5-year history of facial swelling in the left lower quadrant and a 10-month history of relapsing red papules and vesicles in the perioral area resembling hydroa vacciniforme. Histologically, a tissue biopsy showed a dense infiltration of medium-sized atypical lymphocytic cells expressing CD4 and CD56. A diagnosis of cutaneous NK-/T-cell lymphoma was made. The patient was treated with alpha-interferon, valaciclovir hydrochloride, and low-dose prednisone for 2 months. Her skin lesions and lymphoadenopathy resolved initially, but she succumbed to the disease shortly after starting chemotherapy treatment 11 months later. To our knowledge, this is the first case of CD4CD56 NK-/T-cell lymphoma with clinical features resembling hydroa vacciniforme.

Topics: Acyclovir; Adult; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Biopsy; CD4 Antigens; CD56 Antigen; Diagnosis, Differential; Fatal Outcome; Female; Herpesvirus 4, Human; Humans; Hydroa Vacciniforme; Immunohistochemistry; Interferon-alpha; Lymphoma, Extranodal NK-T-Cell; Predictive Value of Tests; Prednisone; Time Factors; Treatment Outcome; Valacyclovir; Valine

Hydroa vacciniforme is a rare, usually quite severe, photo-dermatosis. Association with Epstein-Barr virus infection and a possibly increased risk of lymphoproliferative malignancy have been demonstrated. We describe here four patients with Epstein-Barr virus-associated hydroa vacciniforme treated with acyclovir/valacyclovir therapy with a good clinical response. The children were reported to have less fatigue, fewer eruptions, less scarring, and increased ability to spend time outdoors without provoking new eruptions. This was also in agreement with clinical observations. However, one patient progressed into an anaplastic lymphoma kinase-1-negative anaplastic large-cell lymphoma in the upper jaw. This was preceded by an increase in EBV viral load. Acyclovir/valacyclovir therapy is a safe treatment. Further studies are required to confirm these results.

Topics: Acyclovir; Antiviral Agents; Child; Child, Preschool; DNA, Viral; Drug Therapy, Combination; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Hydroa Vacciniforme; Jaw Diseases; Lymphoma, Large B-Cell, Diffuse; Male; Oral Ulcer; Valacyclovir; Valine