03009nas a2200445   4500000000100000008004100001260001600042653002600058653001100084653001500095653003600110653002300146653002300169653001100192653002500203653000900228653001500237653001600252653002100268653003000289653003000319653000900349653001500358653002200373100002400395700001100419700001200430700001700442700001600459700001800475700001700493700002500510245009600535856006400631300001100695490000600706050002600712520181100738022001402549       2012                            d  c2012 Jun 1510aAnti-Bacterial Agents10aBrazil10aDNA, Viral10aEpidermodysplasia Verruciformis10aHistocytochemistry10aHLA-DQ beta-Chains10aHumans10aLeprosy, Tuberculoid10aMale10aMicroscopy10aMiddle Aged10aPapillomaviridae10aPapillomavirus Infections10apolymerase chain reaction10aSkin10aSkin Tests10aTreatment Outcome1 aPrestes-Carneiro LE1 aNai GA1 aSilva M1 aCristofano C1 aCrivelin LL1 aCalabreta CBR1 aMoliterno RA1 aMorgado de Abreu MAM00aClinical presentation of tuberculoid leprosy in an epidermodysplasia verruciformis patient.  uhttp://www.jidc.org/index.php/journal/article/view/22711134  a526-300 v6  aPRESTES CARNEIRO 20123 a<p>Epidermodysplasia verruciformis (EV) is triggered by a variety of mechanisms that at least partly include genetic background. We present a Brazilian man with a 30-year history of flat, wart-like lesions with clinical, histopathological, and evolutive aspects consistent with papillomavirus (HPV)-associated EV. Histological analysis of the wart lesions showed epidermis with hyperkeratosis, regular acanthosis, hypergranulosis, and cells with abundant basophilic cytoplasm. Moreover, a perivascular lymphocytic infiltrate was found in the superficial dermis, consistent with a viral wart. Type-2-HPV DNA was detected in various fragments of skin-wart lesions using the polymerase chain reaction (PCR). Two years after the EV diagnosis, the patient presented with an anesthetic well-demarcated, erythematous and mildly scaly plaque on his right forearm. A histopathological analysis of this lesion demonstrated the presence of a compact tuberculoid granuloma. Ziehl-Neelsen staining demonstrated the presence of rare acid-fast bacilli and confirmed the tuberculoid leprosy diagnosis. The patient's Mitsuda Intradermal Reaction was positive. To elucidate the possible mechanism involved in this case of EV, we genotyped the HLA genes of this patient. DQB genotyping showed the polymorphic HLA alleles DQB1*0301 and 0501. The patient was treated with a paucibacillary multi-drug therapy scheme, and the disease was cured in six months. This report describes an EV patient with an M. leprae infection, confirming that tuberculoid leprosy patients possess a relatively specific and efficient cell-mediated immunity against the bacillus and, therefore, localized forms of the disease. Moreover, we show the possible involvement of the polymorphic HLA alleles DQB1*0301 and 0501 in EV induction mechanisms.</p>  a1972-2680