Acute HTLV-III infection with roseola-like rash [letter]

The authors present 3 cases of acute human T-lymphotropic virus type III (HTLV-III) infection with a roseola-like rash in homosexual men in Denmark. The 1st case involved a 50-year old homosexual man with a history of syphilis and genital herpes who became ill in June 1985 with severe headache myalgia arthralgia sore throat general malaise and a pruritic rash. There was generalized lymphadenopathy and a macular roseola-like rash on the face trunk and extremities. The symptoms receded in 12 days. Seroconversion to anti-HTLV-III positivity closely related in time to acute illness. In the 2nd case a 23-year old homosexual with a history of syphilis presented in September 1985 with fever a sore throat and a macular roseola-like rash on the trunk. The patient subsequently recovered from seropositivity. The 3rd case involved a 42-year old homosexual man with a history of syphilis who was found to be anti-HTLV-III positive in September 1984. In December 1982 he had presented with fever general malaise headache an a maculopapular rash on the face trunk and extremities. The clinical picture in all 3 patients was virtually identical and similar to that in cases presented by other researchers. The finding during the acute phase of thromocytopenia in all of the patients lymphopenia in 1 patient and a lowered T helper/suppressor ratio in 1 patient is also in line with the results of another study. It is suggested that the characteristic skin eruption which mimics roseola may be a dermatologic marker of acute HTLV-III infection.