Bullous Herpes Zoster

Bullous Disseminated Herpes Zoster: An Atypical Presentation

“…HZ is a transient infection presenting as a painful vesicular rash with lesions <5 mm diameter limited to one dermatome, with no more than 20 lesions outside the affected area [ 6 ]. Disseminated VZV occurs when viremia persists, leading to more than 20 vesicles outside the initial dermatome, with increased probability of visceral involvement [ 2 ].…”

“…Atypical presentation of HZ may challenge the proper diagnosis leading to delayed treatment as it may resemble other disorders. Additionally, there are clinical variants of HZ, including hemorrhagic, necrotizing, and bullous types [ 6 ]. There is scant literature regarding the bullous presentation.…”

“…Similarly, bullous VZV was also diagnosed with PCR test in a three-year old child with leukemia, involving the first, second, and third fingers of right hand (compatibles to C6-C8 dermatomes), treated with IV acyclovir 500 mg three times a day [ 9 ]. Another study reported its occurrence in a 13-year-old girl with chronic glucocorticoid use involving the right neck (C2-C4 dermatomes) treated with foscarnet due to facial angioedema related to acyclovir initially administrated [ 6 ].…”

Bullous varicella in a preschool-aged patient

“…If varicella bullosa occurs in an immunocompromised person, it usually has a severe relapsed course with large elements, poor prolonged healing for more than three weeks, and secondary complications [26,27].…”

“…Despite the fact that toxigenic Staphylococcus aureus is considered to play the main role in the aetiology of varicella bullosa [26,27], in some patients, vesicles cultures were negative [24,25]. Bacterial culture taken from the patient's bullae before initiation of antibacterial therapy was also negative.…”