Clinical, histopathologic, immunohistochemical, and electron microscopic findings in cutaneous monkeypox: A multicenter retrospective case series in Spain.

Background: The worldwide outbreak of monkeypox has evidenced the usefulness of the dermatologic manifestations for its diagnosis. Objective: To describe the histopathologic and immunohistochemical findings of monkeypox cutaneouslesions. Methods: This is a retrospective histopathologic and immunohis...

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Detalles Bibliográficos
Autores: Rodríguez-Cuadrado, Francisco José, Nájera, Laura, Suárez, Dolores, Silvestre, Gala, García-Fresnadillo, Diego, Roustan, Gaston, Sánchez Vázquez, Laura, Jo, Margarita, Santonja, Carlos, Garrido Ruiz, María Concepción, Vicente Montaña, Ana María, Rodríguez Peralto, José Luis, Requena, Luis
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad Francisco de Vitoria
Repositorio:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Idioma:inglés
OAI Identifier:oai:ddfv.ufv.es:10641/5484
Acceso en línea:https://hdl.handle.net/10641/5484
Access Level:acceso abierto
Palabra clave:Dermatopathology
Electron microscopy
Histopathology
Immunohistochemistry
Monkeypox
Virology
Descripción
Sumario:Background: The worldwide outbreak of monkeypox has evidenced the usefulness of the dermatologic manifestations for its diagnosis. Objective: To describe the histopathologic and immunohistochemical findings of monkeypox cutaneouslesions. Methods: This is a retrospective histopathologic and immunohistochemical study of 20 patients with positive Monkeypox virus DNA polymerase chain reaction and immunohistochemical positivity for Vaccinia virus in cutaneous lesions. Four cases were also examined by electron microscopy. Results: The most characteristic histopathologic findings consisted of full-thickness epidermal necrosis with hyperplasia and keratinocytic ballooning at the edges. In some cases, the outer root sheath of the hair follicle and the sebaceous gland epithelium were affected. Intraepithelial cytoplasmic inclusion bodies and scattered multinucleated keratinocytes were occasionally found. Immunohistochemically, strong positivity with anti-Vaccinia virus antibody was seen in the cytoplasm of ballooned keratinocytes. Electron microscopy study demonstrated numerous viral particles of monkeypox in affected keratinocytes. Limitations: Small sample size. Electron microscopic study was only performed in 4 cases. Conclusion: Epidermal necrosis and keratinocytic ballooning are the most constant histopathologic findings. Immunohistochemical positivity for Vaccinia virus was mostly detected in the cytoplasm of the ballooned keratinocytes. These findings support the usefulness of histopathologic and immunohistochemical studies of cutaneous lesions for diagnosis of monkeypox.