Non-dermatomal varicella-zoster skin infection: disseminated cutaneous herpes zoster without dermatome in an immunosuppressed woman.

Abstract

Disseminated herpes zoster is defined as the presence of more than 20 lesions outside the dermatome. This unusual presentation is more common in immunosuppressed patients. Complications such as hepatitis, encephalitis, and pneumonitis are more likely in individuals with disseminated varicella zoster virus infection.A 63-year-old woman being treated for breast cancer developed multiple pustules and vesicles days after starting doxorubicin and cyclophosphamide chemotherapy. Ten individual lesions appeared on her chest, abdomen, back, and leg. Non-dermatomal disseminated herpes zoster was suspected. She was treated with oral antiviral therapy, as well as with oral and topical antibiotics. Varicella zoster virus infection was confirmed by direct fluorescent antibody staining. After one month, her skin lesions had resolved and she resumed chemotherapy.In a setting of immunosuppression, the rare presentation of disseminated herpes zoster without dermatome should be considered. Appropriate antiviral therapy should be administered while waiting for confirmation of the diagnosis, so as to reduce the risk of visceral dissemination of the varicella zoster virus infection.

• Authors: Lindsay P Osborn, Philip R Cohen
• Journal: Dermatology online journal (Dermatol Online J) Vol. 23 Issue 10 (Oct 15 2017) ISSN: 1087-2108 [Electronic] United States
• PMID: 29469780 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antiviral Agents
• Valine
• Valacyclovir
• Acyclovir

Topics

• Acyclovir (analogs & derivatives, therapeutic use)
• Antiviral Agents (therapeutic use)
• Breast Neoplasms (drug therapy)
• Female
• Herpes Zoster (drug therapy, pathology)
• Humans
• Immunocompromised Host
• Middle Aged
• Valacyclovir
• Valine (analogs & derivatives, therapeutic use)