Incidence of herpes family viruses in skin lesions of pemphigus patients

Background: Pemphigus is a group of autoimmune blistering skin diseases that is related to auto antibodies against desmoglein 1 and 3. Many reports have shown that HSV1, HSV2, VZV, EBV, CMV, HHV8, and HIV are triggering agents for the activation and exacerbation of pemphigus. In this study, we decided to evaluate the frequency of HSV1, HSV2, HHV8, and EBV in paraffin-embedded specimens of the new cases of pemphigus patients using immunohistochemical methods. Method: Thirty patients with pemphigus whose diagnosis was proved with direct immunofluorescens studies (20 cases of pemphigus vulgaris and 10 cases of pemphigus foliaceus) and 10 specimens from the free margins of excised melanocytic nevi were collected. Immunohistochemical staining was performed for HSV1 and EBV (using Novo Castra kit) and for HSV2 and HHV8 (using Dako kit). Result: The results showed a significance difference in the frequency of positive staining for HSV1 in skin lesions of pemphigus vulgaris, foliaceus, and controls (P= 0.041), foliaceus group more positive staining than vulgaris group and both more than controls, but not for HSV2, EBV, and HHV8 markers. Positive staining for HHV8 occurred in 30% of PF patients and 15% of PV patients but P value was not significant (0.171). Conclusion: Like previous studies, our research also indicated significant prevalence of HSV1 in lesions of pemphigus patients, especially in pemphigus foliaceus. We collected new cases of pemphigus before starting immunosuppressive therapy, so we think that the presence of HSV1 in skin lesions of patients can act as a triggering factor for the disease which could not be attributed to the suppressive therapy.