“…Interestingly, nine reports explicitly stated that the skin rash was monomorphic and without a "starry sky" appearance. 10,13,15,21,28,31,39,41 The rash was not described in detail in the remaining cases. In 35 cases, the rash was preferentially or exclusively localised in areas of inflammation, as depicted in Table 2.…”
Section: Clinical Datamentioning
confidence: 99%
“…The clinical diagnosis of primary varicella was supported by history of recent exposure to varicella and absence of prior varicella in all cases, by a Tzanck smear in 21 cases and by a positive test for varicella zoster virus in 7 cases. Twentyfour cases were photo-localised [8][9][10][11][12][13][14][15][16][17][18]20,21,23,24,28,30,31,33,38,41,43 and 35 6,7,14,16,19,21,22,[25][26][27]29,30,32,[34][35][36][37]40,42 skin inflammation associated. Females (79%) predominated in the cases with photo-localised varicella, males (57%) in the group with skin inflammation-associated varicella (p < 0.01).…”
Aim
In previously healthy subjects, primary varicella presents with a distinctive vesicular rash that is more intense on the trunk and head than on the extremities. However, an atypical presentation may occasionally develop. We aimed at systematically assessing the characteristics of cases affected by atypical primary varicella rash.
Methods
The United States National Library of Medicine, Excerpta Medica and Web of Science databases were reviewed, without date or language restrictions. Articles were eligible if reporting previously healthy and immunocompetent subjects with a primary varicella rash (i.e., a photo‐localised primary varicella or skin inflammation‐associated primary varicella).
Results
Thirty‐eight reports providing information on 59 cases of atypical primary varicella were identified. Twenty‐four cases (median 8.5 years of age, 19 females) were photo‐localised and 35 (median 4.8 years of age, 15 females) were associated with pre‐existing skin inflammation (including cast occlusion, diaper irritation, operative sites, burns, insect bites, vaccinations or pre‐existing skin disease). The skin rash was monomorphic and without a “starry sky” appearance.
Conclusion
Primary varicella may have a modified presentation in areas of irritation such as sun exposure or pre‐existing inflammation. There is a need for a wider awareness of these modulators of varicella rash.
“…Interestingly, nine reports explicitly stated that the skin rash was monomorphic and without a "starry sky" appearance. 10,13,15,21,28,31,39,41 The rash was not described in detail in the remaining cases. In 35 cases, the rash was preferentially or exclusively localised in areas of inflammation, as depicted in Table 2.…”
Section: Clinical Datamentioning
confidence: 99%
“…The clinical diagnosis of primary varicella was supported by history of recent exposure to varicella and absence of prior varicella in all cases, by a Tzanck smear in 21 cases and by a positive test for varicella zoster virus in 7 cases. Twentyfour cases were photo-localised [8][9][10][11][12][13][14][15][16][17][18]20,21,23,24,28,30,31,33,38,41,43 and 35 6,7,14,16,19,21,22,[25][26][27]29,30,32,[34][35][36][37]40,42 skin inflammation associated. Females (79%) predominated in the cases with photo-localised varicella, males (57%) in the group with skin inflammation-associated varicella (p < 0.01).…”
Aim
In previously healthy subjects, primary varicella presents with a distinctive vesicular rash that is more intense on the trunk and head than on the extremities. However, an atypical presentation may occasionally develop. We aimed at systematically assessing the characteristics of cases affected by atypical primary varicella rash.
Methods
The United States National Library of Medicine, Excerpta Medica and Web of Science databases were reviewed, without date or language restrictions. Articles were eligible if reporting previously healthy and immunocompetent subjects with a primary varicella rash (i.e., a photo‐localised primary varicella or skin inflammation‐associated primary varicella).
Results
Thirty‐eight reports providing information on 59 cases of atypical primary varicella were identified. Twenty‐four cases (median 8.5 years of age, 19 females) were photo‐localised and 35 (median 4.8 years of age, 15 females) were associated with pre‐existing skin inflammation (including cast occlusion, diaper irritation, operative sites, burns, insect bites, vaccinations or pre‐existing skin disease). The skin rash was monomorphic and without a “starry sky” appearance.
Conclusion
Primary varicella may have a modified presentation in areas of irritation such as sun exposure or pre‐existing inflammation. There is a need for a wider awareness of these modulators of varicella rash.
The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.
The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.
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