We read with interest the recent article by Memar et al.1 Although the polymerase chain reaction studies on the biopsy material were convincing, polymerase chain reaction studies of peripheral blood and serologic test results need to be confirmed. In addition, in situ polymerase chain reaction might define which cell populations contain the virus in the skin.
The authors point out that some of the diseases associated with human herpesvirus 8 (HHV-8) are increased in patients with pemphigus, including Kaposi sarcoma, lymphoma, and benign giant lymph node hyperplasia.2 They did not study patients with paraneoplastic pemphigus. Patients with paraneoplastic pemphigus have a much higher association with non–Hodgkin lymphoma, chronic lymphocytic leukemia, and benign giant lymph node hyperplasia (82%) than patients with pemphigus vulgaris and pemphigus foliaceus.3 Most of these neoplasms have been associated with other oncogenic viruses, usually Epstein-Barr virus, but also HHV-8 in some patients with benign giant lymph node hyperplasia.2,4- 6
Smith KJ, Skelton HG. Human Herpesvirus 8 DNA Sequences in Pemphigus: The Role of the Virus in Oncogenic and Autoimmune Manifestations. Arch Dermatol. 1998;134(6):751. doi: