Monkeypox: A Histopathological and Transmission Electron Microscopy Study
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 micros...
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MDPI AG
2023-07-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/11/7/1781 |
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| author | Chiara Moltrasio Francesca Laura Boggio Maurizio Romagnuolo Rachele Cagliani Manuela Sironi Alessandra Di Benedetto Angelo Valerio Marzano Biagio Eugenio Leone Barbara Vergani |
| author_facet | Chiara Moltrasio Francesca Laura Boggio Maurizio Romagnuolo Rachele Cagliani Manuela Sironi Alessandra Di Benedetto Angelo Valerio Marzano Biagio Eugenio Leone Barbara Vergani |
| author_sort | Chiara Moltrasio |
| collection | DOAJ |
| description | 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 <i>Orthopoxvirus</i> infections. |
| first_indexed | 2024-03-11T00:48:57Z |
| format | Article |
| id | doaj.art-85637c95793e4196854f824bbdda93bf |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-11T00:48:57Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-85637c95793e4196854f824bbdda93bf2023-11-18T20:36:21ZengMDPI AGMicroorganisms2076-26072023-07-01117178110.3390/microorganisms11071781Monkeypox: A Histopathological and Transmission Electron Microscopy StudyChiara Moltrasio0Francesca Laura Boggio1Maurizio Romagnuolo2Rachele Cagliani3Manuela Sironi4Alessandra Di Benedetto5Angelo Valerio Marzano6Biagio Eugenio Leone7Barbara Vergani8Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyPathology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyScientific Institute IRCCS E. MEDEA, Bioinformatics, 23842 Bosisio Parini, ItalyScientific Institute IRCCS E. MEDEA, Bioinformatics, 23842 Bosisio Parini, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, ItalyThe 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 <i>Orthopoxvirus</i> infections.https://www.mdpi.com/2076-2607/11/7/1781monkeypoxvirologycutaneous manifestationshistopathologytransmission electron microscopy |
| spellingShingle | Chiara Moltrasio Francesca Laura Boggio Maurizio Romagnuolo Rachele Cagliani Manuela Sironi Alessandra Di Benedetto Angelo Valerio Marzano Biagio Eugenio Leone Barbara Vergani Monkeypox: A Histopathological and Transmission Electron Microscopy Study Microorganisms monkeypox virology cutaneous manifestations histopathology transmission electron microscopy |
| title | Monkeypox: A Histopathological and Transmission Electron Microscopy Study |
| title_full | Monkeypox: A Histopathological and Transmission Electron Microscopy Study |
| title_fullStr | Monkeypox: A Histopathological and Transmission Electron Microscopy Study |
| title_full_unstemmed | Monkeypox: A Histopathological and Transmission Electron Microscopy Study |
| title_short | Monkeypox: A Histopathological and Transmission Electron Microscopy Study |
| title_sort | monkeypox a histopathological and transmission electron microscopy study |
| topic | monkeypox virology cutaneous manifestations histopathology transmission electron microscopy |
| url | https://www.mdpi.com/2076-2607/11/7/1781 |
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