Clinical, histopathologic, immunohistochemical, and electron microscopic findings in cutaneous monkeypox: A multicenter retrospective case series in Spain - 16/03/23
, Laura Nájera, MD b, Dolores Suárez, MD b, Gala Silvestre, MD b, Diego García-Fresnadillo b : Pathology Technician, Gaston Roustan, MD a, Laura Sánchez-Vázquez, MD c, Margarita Jo, MD c, Carlos Santonja, MD c, María Concepción Garrido-Ruiz, MD d, Ana María Vicente-Montaña, MD e, José Luis Rodríguez-Peralto, MD d, Luis Requena, MD fAbstract |
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 cutaneous lesions.
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.
Il testo completo di questo articolo è disponibile in PDF.Key words : dermatopathology, electron microscopy, histopathology, immunohistochemistry, monkeypox, virology
Abbreviation used : TEM
Mappa
| Funding sources: None. |
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| IRB approval status: Reviewed and approved by the research ethics committee of Hospital Universitario Puerta de Hierro Majadahonda on August 29, 2022. |
Vol 88 - N° 4
P. 856-863 - aprile 2023 Ritorno al numero
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