Varicella Zoster With Pemphigus-like Reaction

Am J Dermatopathol. 2022 Jul 1;44(7):e75-e78. doi: 10.1097/DAD.0000000000002178. Epub 2022 Mar 21.

Abstract

We present a case of a 55-year-old man with a rash on his right foot that was biopsied and diagnosed as a Varicella Zoster virus infection with an accompanying positive immunohistochemical study with antiviral antibodies. He concomitantly suffered from a Varicella Zoster virus meningitis. The skin biopsies not only showed clear histologic signs of viral cytopathic effects but also showed intercellular IgG and C3 intraepidermal staining by direct immunofluorescence study, findings which are typically consistent with pemphigus vulgaris. However, the patient did not have any history of pemphigus; there was no mucosal involvement, and serum antibodies to desmoglein 1 and 3 were negative. After discharge, the patient continued to have right-sided foot pain, and he continued the acyclovir treatment.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use
  • Chickenpox* / complications
  • Herpes Zoster* / complications
  • Herpes Zoster* / drug therapy
  • Herpesvirus 3, Human
  • Humans
  • Male
  • Middle Aged
  • Pemphigus* / pathology
  • Varicella Zoster Virus Infection* / complications
  • Varicella Zoster Virus Infection* / drug therapy

Substances

  • Antiviral Agents
  • Acyclovir