Detection of human parvovirus B19 DNA in 22% of 1815 cutaneous biopsies of a wide variety of dermatological conditions suggests viral persistence after primary infection and casts doubts on its pathogenic significance. (7th September 2017)

• Record Type: Journal Article
• Authors: Santonja, C.; Santos‐Briz, A.; Palmedo, G.; Kutzner, H.; Requena, L.
• Is Part Of: British journal of dermatology. Volume 177:Number 4(2017)
• Page Start: 1060
• Page End: 1065
• Publication Date: 2017-09-07
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.15382
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Human parvovirus B19 (B19V) has been associated with a number of dermatological and systemic conditions, including myocarditis and autoimmune syndromes. Objectives: To determine the frequency of B19V DNA detection in a large dermatopathology practice, and to characterize the histopathological patterns involved. Methods: We selected for polymerase chain reaction (PCR) detection of B19V a total of 1815 skin biopsies pertaining to entities allegedly related to B19V, as well as cases suspected clinically of representing paraviral exanthemas. Immunohistochemical detection of B19V viral protein 2 (VP2) was performed in 92 PCR‐positive cases. Results: B19V DNA was found by PCR in 402 out of 1825 biopsy specimens (22%). VP2 protein was identified by immunohistochemistry in only three instances of papular purpuric 'gloves‐and‐socks' syndrome. Conclusions: As the virus has the capacity to persist in different tissues (including the skin) for long periods, it could represent merely an innocent bystander, so no pathogenetic significance can be inferred from the PCR positivity for B19V in the vast majority of dermatological conditions studied. Abstract : What's already known about this topic? Many dermatological diseases have been linked to parvovirus B19 infection due, among other evidence, to the presence of viral DNA in tissue specimens. What does this study add? Polymerase chain reaction detection of viral DNA in 22% of 1825 tested cases confirms data of previous shorter series and casts doubts on a pathogenic role for parvovirus B19 (B19V) in these conditions. What is the translational message? We have found B19V DNA in skin biopsies showing the full spectrum of histopathological inflammatory patterns in a wide variety of dermatological ailments. As B19V persists in the skin, additional studies (e.g. seroconversion, detection of B19V DNA in serum samples or immunohistochemical demonstration of B19V in endothelial cells of the papillary dermis) are required in order to link pathogenetically, a given cutaneous disorder with B19V. Linked Comment:Söderlund‐Venermo. Br J Dermatol 2017; 177:900–901 . Plain language summary available online