Late-onset Parry–Romberg syndrome in a patient with newly diagnosed HIV-2 infection

Claúdia Brazão, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal Dora Mancha, Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal Lanyu Sun, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal Sofia Antunes-Duarte, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal Diogo de Sousa, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal Pedro de Vasconcelos, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal Luís Soares-de-Almeida, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal Paulo Filipe, Dermatology and Venereology Department, Hospital de Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal; Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Dermatology Research Unit, iMM João Lobo Antunes, University of Lisbon, Lisbon, Portugal

Sclerodermoid syndromes encompass a wide spectrum of rare diseases, with variable clinical presentation and severity. We present a case of a 31-year-old woman, Fitzpatrick’s phototype V, who presented to our dermatology department with a 5-year history of linear atrophy of her right hemiface, which rapidly progressed during the first 2 years and then stabilized. There were no identifiable triggers, namely, drugs, infections, or trauma. Physical examination revealed a linear depression on her right hemiface, alongside a mild right enophthalmos. Laboratory examination revealed a positive human immunodeficiency virus (HIV) type 2 serology, with detectable viral load. The skin biopsy was compatible with late-stage morphea. The diagnosis of Parry–Romberg syndrome and HIV-2 infection was established. This patient illustrates a case of late-onset Parry–Romberg syndrome, in which HIV-2 infection may have been the trigger, due to a possible mechanism of molecular mimicry.

Keywords: Human immunodeficiency virus. Localized scleroderma. Parry–Romberg syndrome. Progressive facial hemiatrophy.