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It is characterised by a chronic exudative eczematous eruption and persistent infection with\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (\n                    <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\n                    ) and beta\u2010haemolytic streptococci (\n                    <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>\n                    ). Prevalence is highest in the Caribbean and Brazil; however, cases have been reported in other\n                    <jats:styled-content style=\"fixed-case\">HTLV<\/jats:styled-content>\n                    \u20101 endemic regions. Approximately 20 million people worldwide are infected with\n                    <jats:styled-content style=\"fixed-case\">HTLV<\/jats:styled-content>\n                    \u20101 and only 5\u201310% suffer from disease. Other manifestations include adult T\u2010cell leukaemia\/lymphoma (\n                    <jats:styled-content style=\"fixed-case\">ATLL<\/jats:styled-content>\n                    ) and tropical spastic paraparesis\/\n                    <jats:styled-content style=\"fixed-case\">HTLV<\/jats:styled-content>\n                    \u20101\u2010associated myelopathy (\n                    <jats:styled-content style=\"fixed-case\">TSP<\/jats:styled-content>\n                    \/\n                    <jats:styled-content style=\"fixed-case\">HAM<\/jats:styled-content>\n                    ).\n                    <jats:styled-content style=\"fixed-case\">HAID<\/jats:styled-content>\n                    may also progress to\n                    <jats:styled-content style=\"fixed-case\">ATLL<\/jats:styled-content>\n                    or\n                    <jats:styled-content style=\"fixed-case\">TSP<\/jats:styled-content>\n                    \/\n                    <jats:styled-content style=\"fixed-case\">HAM<\/jats:styled-content>\n                    . Treatment options are limited to prolonged antibiotic therapy. The aim of this paper is to review existing evidence and propose new theories on the pathogenesis of\n                    <jats:styled-content style=\"fixed-case\">HAID<\/jats:styled-content>\n                    . The current view is that\n                    <jats:styled-content style=\"fixed-case\">HTLV<\/jats:styled-content>\n                    \u20101 infection is required and in susceptible individuals leads to immune dysregulation with subsequent immunosuppression and superinfection with\n                    <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\n                    and\n                    <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>\n                    . Evidence suggests that host, environment and genetic factors may play a causative role. Genetic factors within ethnic groups determine host immune response and carrier state or disease manifestation of\n                    <jats:styled-content style=\"fixed-case\">HTLV<\/jats:styled-content>\n                    \u20101 infection. Increased IgE levels may contribute to the\n                    <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\n                    and\n                    <jats:styled-content style=\"fixed-case\">BHS<\/jats:styled-content>\n                    superinfection in\n                    <jats:styled-content style=\"fixed-case\">HAID<\/jats:styled-content>\n                    . Additionally, the possible impact of filaggrin, skin proteinase dysregulation, Langerhans cell dysfunction and\n                    <jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content>\n                    2 chemokines is highlighted. More than 45\u00a0years since the discovery of\n                    <jats:styled-content style=\"fixed-case\">HAID<\/jats:styled-content>\n                    , the exact pathogenesis is still not fully understood. Further research is still needed to clearly elucidate the exact pathogenic mechanism of\n                    <jats:styled-content style=\"fixed-case\">HAID<\/jats:styled-content>\n                    .\n                  <\/jats:p>","DOI":"10.1111\/exd.12007","type":"journal-article","created":{"date-parts":[[2012,8,14]],"date-time":"2012-08-14T11:57:40Z","timestamp":1344945460000},"page":"815-821","source":"Crossref","is-referenced-by-count":45,"title":["<scp>HTLV<\/scp>\n                    \u20101\u2010associated infective dermatitis: updates on the pathogenesis"],"prefix":"10.1111","volume":"21","author":[{"given":"Neilia\u2010Kay","family":"McGill","sequence":"first","affiliation":[{"name":"Department of Dermatology and Wound Healing Institute of Infection and Immunity Cardiff University Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Wound Healing 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