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Herpes incognito.

K S Resnik1, M DiLeonardo

  • 1Institute for Dermatopathology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.

The American Journal of Dermatopathology
|April 19, 2000
PubMed
Summary
This summary is machine-generated.

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Microscopists can suspect herpesvirus infection even without obvious epithelial changes. Look for atypical lymphocytes alongside unusual inflammatory infiltrates as potential indicators of herpesvirus.

Area of Science:

  • Pathology
  • Virology
  • Histopathology

Background:

  • Herpesvirus infections (varicella, zoster, simplex) often present with characteristic epithelial changes detectable via histopathology.
  • Diagnosing herpesvirus infection can be challenging when these typical epithelial changes are absent in biopsy specimens.

Observation:

  • This study examined punch-biopsy specimens where initial histopathologic examination did not reveal clear signs of herpesvirus infection.
  • Step sections in some cases uncovered focal diagnostic changes indicative of herpesvirus.
  • Atypical lymphocytes were consistently observed in these challenging cases.

Findings:

  • The presence of atypical lymphocytes, particularly when associated with an ill-defined inflammatory infiltrate pattern, should prompt consideration of herpesvirus infection.

Related Experiment Videos

  • A review of confirmed herpesvirus cases showed that atypical lymphocytes were present in over two-thirds (32/45) of specimens, often accompanying characteristic epithelial changes.

    • Implications:

    • This finding aids microscopists in suspecting herpesvirus infection even in the absence of definitive epithelial alterations.
    • Recognizing atypical lymphocytes in specific inflammatory contexts can improve the early diagnosis of herpesvirus infections.
    • Enhances diagnostic capabilities in challenging histopathologic cases of viral infections.