Actinic Varicella

Photolocalized varicella in an adult

“…The first case of photolocalized varicella was reported by Castrow and Wolf . Subsequently, several infant cases have been reported, but an adult case is extremely rare . The pathogenesis of specific localization and simultaneous single‐stage eruptions of photoinduced varicella is still unknown, but there are several hypotheses .…”

Acute Generalized Varicella Zoster in the Setting of Preexisting Generalized Erythema

“…This presentation complicated the clinical diagnosis by the absence of the typical finding of lesions in all stages of development simultaneously. This presentation, although rare, has been previously reported, especially in the erythema following sunburn, where monomorphous vesicles occur just in the sunburned areas ( 2–5). It is not known why varicella lesions localize to areas of erythema as monomorphous vesicles.…”

An Unusual Photodistributed Rash

“…They used the term “photolocalization” to indicate the preferential distribution of the viral infectious agent in the ultraviolet (UV) light–damaged skin. Other cases have been reported in both children () and adults (). A review of the literature revealed that the photodistributed chickenpox rash is usually characterized by monomorphous elements that appear together and in a simultaneous stage ().…”

“…Exposure to UV radiation is known to suppress cutaneous cell–mediated immunity and could enhance the spread and increase the severity of the viral infection. Moreover, UV light exposure causes vasodilatation and increases local temperature and capillary permeability in the skin, allowing easier spread of the varicella zoster virus in sun‐exposed areas (). In addition, UV radiation induces damage in epidermal cell membranes, leading to easier spread of typical varicella manifestations in tanned or sun‐exposed areas.…”