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Case Reports in Medicine
Volume 2017 (2017), Article ID 1650841, 4 pages
https://doi.org/10.1155/2017/1650841
Case Report

Herpes Simplex Virus and Human Papillomavirus Coinfections in Hyperimmunoglobulin E Syndrome Presenting as a Conjunctival Mass Lesion

1Eye Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
2Legal Medicine Organization, Rasht, Guilan, Iran

Correspondence should be addressed to Mitra Akbari; moc.liamg@02irabka.artim

Received 23 May 2017; Revised 20 August 2017; Accepted 14 September 2017; Published 12 October 2017

Academic Editor: Lothar Bergmann

Copyright © 2017 Mitra Akbari and Ramin Elmi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hyperimmunoglobulin E syndrome (HIES) or Job’s syndrome is a rare immunodeficiency disease with less than 200 cases reported worldwide, among which few cases are reported with lesions due to herpes simplex virus (HSV) or human papillomavirus (HPV). This case study presents a rare case of HIES with coinfection of HSV and HPV. A 12-year-old boy, previously diagnosed with HIES, presented with a large conjunctival mass lesion. The presence of HPV in the lesion was confirmed by biopsy and by using the line-probe assay method to detect the HPV genome. However, the mass lesion did not respond to anti-HPV therapy with topical interferon-α2b (IFN-α2b) and oral cimetidine but improved promptly after intravenous (IV) acyclovir, which is often administered for cutaneous herpetic lesions. This suggested the presence of HSV in the conjunctival mass. Review of pathology and HSV immunohistochemical staining confirmed the presence of HSV as a coinfection. The likelihood that the mass arose from an abnormal host response to HSV and HPV due to HIES was considered, but coexisting infection with these two viruses and HIES has not been reported in the literature; therefore, such cases require further investigation.