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KMID : 0350519950480041111
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Journal of Catholic Medical College
1995 Volume.48 No. 4 p.1111 ~ p.1120
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Clinical and Histopathological Finding, Viral DNA Distribution and Immunohistochemical Study in Vesicular Type and Papular Type of Herpes Zoster
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Abstract
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Characteristic rash of herpes zoster begins as erythematous macules and papules within the affected dermatome. T hese lesions progress to vesicles within 12-24 hours, to pustules in 3-4 days, and to crusts in 7-1- days. But we could
occasionally
find patients who have persistent papules without vesicular change.
This investigation was performed to assess differences between vesiculat type and papular type in herpes zoster. We did clinical and histopathological observations in 13 vesicular type patients and 8 papular type patients. Multi-test(r)CMI kit
was
used
to evaluate cell mediated immunity and in situ hybridization with varicella zoster virus DNA probe was performed to see viral distribution. Immunohistochemical staining was done to see phenotypes of infiltrated inflammatory cells with several
monoclonal
antibodies.
@ES Results were as follows :
@EN 1. Cell mediated immunity to several recall antiens was decreased in both types and there was no difference between vesicular type and papular type.
2. Vesicular type lesions showed celluiar ballooning with acanthoysis within and around the vesicles. Necrotic follicles were also found in 4 cases of vesicular type that showed hair follicles in the tissue section. Papular type lesions showed
only
compact necrotic change without vesicle formation in the vesicle formation in the superficial part of hair follicle.
3. The DNA of varicella-zoster virus was detected within and around the vesicles in all cases of vesicular type. In 4 cases of vesicular type, the viral DNA was also detected in the hair follicle associated with vesicle. In papular type, the
viral
DNA
was only detected in the hair follicle or pilosebaceous unit. The viral DNA was found in the dermis beneath the vesicles in 5 cases of vesicular type and in the dermis near the hair follicle in one case of papular type.
4. There was on difference in composition of infiltrated inflammatory cells between vesicular and papular type. Inflammatory cells infiltrated in perivascular area were mainly memory T lymphocytes in both types. The ratio of CD4/CD8 positive
cells
was
about 1 : 1 in both types.
In our experimental bobservations, it can be suggested that the appearance of clinical types in herpes zoster depends on the infected site of varicella-zoster virus in the tissue.
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KEYWORD
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