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Expression of Epstein-Barr virus in children with sacrococcygeal pilonidal sinus determined by immunohistochemical
Esra Karakuş1, Ayper Kaçar2, Resul Karakuş3
1Pathology Department, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
Insights
Epstein-Barr virus (EBV) can replicate in chronic skin infections like pilonidal sinus. EBV presence in these lesions is linked to increased inflammation and recurrence of the condition.
Area of Science:
- Immunology
- Dermatology
- Virology
Background:
- Pilonidal sinus is a chronic skin infection known for its high recurrence rates.
- The potential role of Epstein-Barr virus (EBV) in the pathogenesis and recurrence of pilonidal sinus remains largely unexplored.
Purpose of the Study:
- To investigate whether chronic skin infections, specifically pilonidal sinus, serve as a site for Epstein-Barr virus (EBV) replication.
- To determine the correlation between EBV presence and the recurrence of pilonidal sinuses.
Main Methods:
- Immunohistochemical staining was performed on 36 sacrococcygeal pilonidal sinus patient samples.
- Samples were analyzed for the expression of EBV, CD3, and CD20 (a B-cell marker).
Main Results:
- Epstein-Barr virus (EBV)-positive B cells (CD20+) were detected in 27% of pilonidal sinus specimens.
- EBV expression was more frequent in lesions with severe inflammation compared to those with minimal or moderate inflammation.
- Recurrence of pilonidal sinus was observed more frequently in EBV-positive cases.
Conclusions:
- The skin, particularly in chronic lesions like pilonidal sinus, can act as a reservoir for Epstein-Barr virus (EBV).
- EBV infection in pilonidal sinuses is associated with increased inflammation and a higher likelihood of recurrence.
- These findings suggest a potential role for EBV in the pathogenesis and chronicity of pilonidal sinus disease.
Abstract:
In this study, we probed whether chronic infections of skin such as pilonidal sinus could be a potential site of Epstein-Barr virus (EBV) replication. Pilonidal sinus is associated with a high recurrence rate. Therefore, we decided to determine the role of EBV's presence to explain whether it is correlated with the recurrence of pilonidal sinuses. This study was conducted on 36 patient samples with sacrococcygeal pilonidal sinus. Samples were immunohistochemically stained for EBV, CD3 and CD20 expression. Thirty-six adolescents with pilonidal disease were evaluated. EBV-positive cells were located in dermis with high inflammatory activity. EBV-positive cells stained positive for the B-cell antigen CD20 and were detected in 10 of 36 (27%) pilonidal sinus specimens. Among those who had experienced a relapse, three were positive for EBV expression. In addition, EBV expression was detected in eight cases with severe inflammation, and in two with minimal or moderate inflammation. Our study advances the field by demonstrating that similar to gastrointestinal mucosa, skin could be a reservoir for EBV. EBV was found to be restricted to B cells in skin lesions, and it was found that skin lesions with severe inflammation showed higher frequency of EBV expression in comparison to minimal or moderately inflammed skin lesions. Additionally, recurrence was more frequently observed among EBV-positive cases. These findings point out for a role of EBV infection in the recurrence of pilonidal sinuses.
