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Objectives To discuss the current knowledge of 3 recently discovered human herpesviruses (HHV-6, HHV-7, and HHV-8), and to provide a dermatological point of view. Data Sources References identified from bibliographies of pertinent articles in the English language. Study Selection and Data Extraction Articles were selected according to their impact factor and the interest for dermatologists. Data Synthesis As the other members of the family Herpesviridae, HHV-6, HHV-7, and HHV-8 may cause a primary infection, establish latent infection in a specific set of cells of their host, and then reactivate if conditions of altered immunity develop. The main pathological conditions associated with them are discussed. Conclusions Human herpesvirus 6, HHV-7, and HHV-8 have provided new insights in some dermatological diseases. Although new studies are needed, they may have a profound impact on dermatology in the years to come.

• Background.— Erythema multiforme (EM) has been rarely reported in Epstein-Barr virus (EBV)—associated diseases; this includes patients with chronic fatigue syndrome who have chronic or recurrent and disabling illness and an abnormal antibody reactivity to EBV. We describe a patient fulfilling the chronic fatigue syndrome diagnostic criteria who had developed an unusually persistent EM resistant to corticosteroids therapy. The EBV DNA was studied in skin EM lesions, throat washings, peripheral mononuclear cells, and plasma. The EBV antigens were studied in skin EM lesions and in mononuclear cells. The patient was followed up to 2 years. Observations.— The patient had abnormal titers of antibodies against various EBV antigens and by immunofluorescence she disclosed the EBV nuclear antigen and the viral capsid antigen in the blood vessels of the affected skin. The dot blot hybridization assay detected viral DNA in throat washings and mononuclear cells, but not in plasma. The presence of the viral genomic content in lesional skin is suggested by the autoradiographic signal and by the difference from appropriate control specimens. Skin lesions and constitutional symptoms cleared after acyclovir sodium therapy and recurred after discontinuation of this therapy. Conclusions.— This is the first EM case in which evidence of the EBV causal role has been provided. The association with chronic fatigue syndrome suggests the EBV role in selected cases of this syndrome. ( Arch Dermatol. 1992;128:217-222)

The statement by Lebbe et al 1 that the detection of human herpesvirus (HHV) 8 sequences in peripheral blood mononuclear cells (PBMCs) of patients with Kaposi sarcoma (KS) is related to the tumor burden seems hazardous. This conclusion is contrary to all we know of HHV biological behavior. For none of the HHVs has the amount or even the existence of latently infected cells been correlated with a clinical disease or viral diffusion in other tissues. Indeed, some, if not all, of the known HHVs are carried by PBMCs in healthy individuals. For example, in Italy, using polymerase chain reaction (PCR), we recently detected HHV-7 DNA sequences in PBMCs in 11 (44%) of 25 healthy individuals.2 As for HHV-8, its sequence has been detected in the blood of healthy individuals. This virus is so widespread that in the American population approximately 25% of adults and 2% to 8% of children

REPORT OF A CASE A 67-year-old woman presented for an array of small red lesions. The number of lesions increased during the weeks before her presentation; a few of them had been present for years. She suffered from epistaxis for 5 months. Blood flow was so copious that she was hospitalized; no definite diagnosis had been made there. The bleeding contributed to her poor general condition, for which she received many transfusions. She denied any similar condition in her family. On examination, some small telangiectases were seen on her face, trunk, limbs, palms, and periungual areas (Fig 1). They were more numerous on the nasal and conjunctival mucosa. The mucosa of the lips, gums, tongue, and the entire mouth was also involved (Figs 2 and 3). Routine laboratory tests revealed the following results or values: hypochromic microcytic anemia (erythrocytes, 3.4×10 9 /L, with hemoglobin, 0.79; hematocrit, 0.27; and mean corpuscular