Viruses and pemphigus: an intriguing never-ending story.

Virus infections and autoimmunity have long been linked. As to pemphigus, many studies have been directed to prove or rule out the possibility of viral induction. Herpesviruses have often been related to the onset or reactivation of pemphigus.

The immunocompromised district in dermatology: A unifying pathogenic view of the regional immune dysregulation.

Besides the systemic immune deficiency, a sectorial default in immune control may occur in immunocompetent subjects. This regional immune defect can appear and remain confined to differently damaged skin areas, lately labeled immunocompromised districts (ICDs). An ICD is a skin area more vulnerable than the rest of the body for genetic or acquired reasons.

Wolf's post-herpetic isotopic response: Infections, tumors, and immune disorders arising on the site of healed herpetic infection.

Herpes simplex viruses (HSV-1/HSV-2) and varicella-zoster virus (VZV) have several characteristics in common. Both are epidermoneurotropic, cause skin eruptions accompanied by sensory symptoms (itch, pain), damage peripheral sensory nerve fibers and cutaneous nerve endings, and interfere with neuromediator release, which can alter local mechanisms of immune control. For this reason, herpes-infected areas may become a preferential location for the subsequent onset of immunity-related skin disorders (infections, tumors, and dysimmune reactions), an event first reported by a neurologist and focused on by two brothers, a dermatologist and a pediatrician.

Monolesional Kaposi sarcoma at the site of slow healing herpes zoster in an HIV+ patient: immunocompromised district in an immunocompromised patient.

Besides the well-known systemic immune deficiency, also a regional immune deficiency, labeled as "immunocompromised district" (ICD), has been documented and focused in the recent years. The objective of the study is to gain more insights into the mechanisms involved in systemic and local immune destabilization. A 35-year-old, homosexual, and drug-addicted HIV+ man presented with a single nodule of Kaposi sarcoma (KS) located on the penis, where a slow to heal herpes zoster had appeared 2 months before.

Pemphigus: associations and management guidelines: facts and controversies.

Pemphigus, a prototypical organ-specific human autoimmune disease, may be associated with other immunity-related disorders, viral infections, and different types of tumors. Coexistence with immune diseases is fairly frequent and, for some of them (eg, myasthenia gravis, Basedow's disease, rheumatoid arthritis, or lupus erythematosus), common pathogenic mechanisms can be considered. The association with viral infections (mainly herpesvirus infections) raises the question of whether the virus triggers the outbreak of the disease or simply complicates its clinical course.

Pemphigus: etiology, pathogenesis, and inducing or triggering factors: facts and controversies.

Pemphigus includes a group of autoimmune bullous diseases with intraepithelial lesions involving the skin and Malpighian mucous membranes. Pemphigus vulgaris (PV), the most frequent and representative form of the group, is a prototypical organ-specific human autoimmune disorder with a poor prognosis in the absence of medical treatment. The pathomechanism of PV hinges on autoantibodies damaging cell-cell cohesion and leading to cell-cell detachment (acantholysis) of the epidermis and Malpighian mucosae (mainly oral mucosa).

Discoid lupus erythematosus at a site of previous injury.

A 71-year-old man with three patches of discoid lupus erythematosus (DLE) confined to the right preauricular region drew our attention because of the unusual linear arrangement of the lesions. Twenty-five years previously, the patient had suffered a trauma in the same area from falling off his motorcycle. We believe that, despite the great lapse in time, this injury may have facilitated the onset of DLE in the very same area, through long-term destabilization of the local neuroimmune network.

Beyond zoster: sensory and immune changes in zoster-affected dermatomes: a review*.

Neuroepidermal tropism of varicella-zoster virus accounts for cutaneous and nerve lesions following herpes zoster. Skin lesions heal in a few weeks and may or may not leave visible scars. Nerve lesions involve peripheral sensory fibres, sometimes causing permanent damage that results in partial denervation of the affected dermatome.

Opportunistic localization of skin lesions on vulnerable areas.

Genetic, developmental, and immune defects can make certain anatomic areas of the body more prone than others to harbor skin lesions. Cutaneous areas with skin barrier dysfunction (eg, atopic dermatitis) are the clearest example of vulnerable sites where opportunistic diseases, mainly infections (eg, herpes simplex), can easily occur. Somatic mosaicism, by giving rise to mutated cell clones with a bandlike arrangement, may form tissue segments prone to developing congenital or acquired skin disorders.

Wolf's isotopic response.

The term "isotopic response" was coined by Wolf et al in 1995 to describe the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease. When this term was found to be unsuitable for Medline searches because it generated hundreds of references that were linked with radioactive isotopes, it was changed to "Wolf's isotopic response" and eventually included as such in Stedman's Illustrated Dictionary of Dermatology Eponyms. Our search of the literature yielded 176 cases of Wolf's isotopic response.

Vesicular and bullous disorders: pemphigus.

Pemphigus is a chronic, autoimmune disease involving the skin and Malpighian mucous membranes. Pemphigus leads to progressive blistering and subsequent erosions. This article describes the etiology and treatment of pemphigus.