PDF(Pubmed)
Abstract：
The global outbreak of human monkeypox virus (hMPXV1) in 2022 highlighted the usefulness of dermatological manifestations for its diagnosis. Infection by the human monkeypox virus thus necessitated inclusion in the diagnostic repertoire of dermatopathology. To assess the histopathological and microscopical findings of cutaneous lesions related to hMPXV infection, we analyzed skin biopsies from patients with positive MPXV DNA polymerase chain reaction presenting with a typical course of hMPXV1 infection. The most prominent histopathological findings were ascribable to a pustular stage in which epidermal necrosis with areas of non-viable keratinocytes and a \"shadow cell\" appearance were evident; in some cases, the deep portion of the hair follicle and the acrosyringial epithelium were affected. The main cytopathic modifications included ballooning keratinocytes, followed by Guarnieri bodies and a ground glass appearance of the keratinocytes\' nuclei, together with a dense mixed inflammatory cell infiltrate with prominent neutrophil exocytosis. Transmission electron microscopy analysis demonstrated viral particle aggregates in the cytoplasm of keratinocytes, without any involvement of the nucleus. Interestingly, we also found the presence of viral particles in infected mesenchymal cells, although to a lesser extent than in epithelial cells. Through this study, we contributed to expanding the histological and microscopic knowledge of the human mpox virus, a key step to understanding current and potential future trends of the disease, as well as of other Orthopoxvirus infections.
摘要：
2022年全球爆发的人类猴痘病毒（hMPXV1）突出了皮肤病学表现对其诊断的有用性。因此，人类猴痘病毒的感染需要纳入皮肤病理学的诊断库。评估与hMPXV感染相关的皮肤病变的组织病理学和显微镜检查结果，我们分析了MPXVDNA聚合酶链反应阳性患者的皮肤活检，这些患者表现为hMPXV1感染的典型病程。最突出的组织病理学发现归因于脓疱期，其中表皮坏死具有不可存活的角质形成细胞区域和“阴影细胞”外观明显；在某些情况下，毛囊的深部和肩腺上皮受到影响。主要的细胞病变修饰包括气球样角质形成细胞，其次是Guarnieri身体和角质形成细胞核的毛玻璃外观，连同密集混合的炎症细胞浸润和明显的中性粒细胞胞吐。透射电子显微镜分析显示病毒颗粒聚集在角质形成细胞的细胞质中，没有任何核的参与。有趣的是,我们还发现感染的间充质细胞中存在病毒颗粒，尽管程度低于上皮细胞。通过这项研究,我们为扩大人类痘病毒的组织学和微观知识做出了贡献，了解该疾病当前和潜在未来趋势的关键步骤，以及其他正痘病毒感染。
