Granuloma annulare in a site of healed herpes zoster: Wolf''s isotopic response

A case of granuloma annulare that developed in a site of healed herpes zoster is reported. Polymerase chain reaction failed to detect VZV DNA in a biopsy specimen. The occurrence of different types of cutaneous reactions in a body area previously affected by herpes virus infection is known as Wolf's isotopic response. Pathogenesis may be due to a local neuroimmune dysregulation set off by herpesvirus-induced lesions of dermal sensory nerve fibres.     

Wolf's isotopic response: rosacea appearing at the site of healed herpes zoster

A 40-year-old man developed an erythematous rash on the right side of his face 3 weeks after a herpes zoster infection at the same location. Examination revealed an erythematous papular eruption and telangiectasias along the ophthalmic and maxillary divisions of the right trigeminal nerve, exactly at the site of the consistent with previous herpes zoster infection, Wolf's isotopic response. Histological examination showed vascular ectatic dilatation and perivascular and perifollicular infiltration of lymphocytes and histiocytes consistent with rosacea. The rash was resistant to oral doxycycline and topical metronidazole 1% cream and resolved with oral isotretinoin therapy.     

Wolf's isotopic response: Trichophyton rubrum folliculitis appearing on a herpes zoster scar

A 37‐year‐old man was first seen in November 1998 with a unilateral painful eruption of grouped small vesicles at the right side of his thorax. His general health was good. He was diagnosed as having herpes zoster, which was successfully, treated with oral acyclovir 800 mg, five times a day. Five months later, and after complete resolution of the herpes zoster, he developed a pustular eruption on exactly the same area of his first herpetic lesion. There was a diffuse distribution of pustules on the dorsal part of the dermatome, and a grouped pattern on the ventral side ( Fig. 1 ). A punch biopsy was performed for differential diagnosis of recurrent herpes zoster and folliculitis. Methicillin‐resistant Staphylococcus aureus colonies were isolated from the bacterial culture of the pustular content. Cefadroxil monohydrate 500 mg twice a day and the application of fucidic acid ointment were prescribed. There was no improvement at the end of the second week of therapy.

Figure 1 Open in figure viewer PowerPoint Clinical appearance     

带状疱疹皮损部位继发环状肉芽肿一例

患者,男,63岁,因右肩背及右臂起红斑、丘疱疹伴疼痛3 d,在当地医院诊为带状疱疹,予阿昔洛韦、维生素B1口服。1个月后皮损完全消退,但右肩背及右臂仍有明显的神经疼痛。疱疹皮损完全消退后2周,患者发现在相同部位出现红斑丘疹,皮损无明显症状……     

Wolf's isotopic response: a case of zosteriform lichen planus on the site of healed herpes zoster

Based on histological findings, the patient had lichen planus. The clinical picture suggests Wolf's isotopic response on the site of healed herpes zoster. These conditions taken into account lead to the diagnosis of zosteriform lichen planus. Lichenoid papules in a dermatomal arrangement are extremely rare. The clinical, dermoscopic and histological features of this case are described.     

Two cases of reactive perforating collagenosis arising at the site of healed herpes zoster.

Case 1 A 67‐year‐old South Korean woman presented with a painful eruption on the left trunk. Several groups of vesicles with an erythematous and edematous base were situated unilaterally within the distribution of the left T9 dermatome; they had been present for 7 days. A diagnosis of herpes zoster was made, and treatment with acyclovir, analgesics, tranquilizers, and wet dressings produced a moderate response. Two weeks after onset, the lesions appeared to have healed with a scar. Four months later, however, the patient noticed another eruption of papules in the postherpetic area ( Fig. 1A,B ).

Figure 1 Open in figure viewer PowerPoint Case 1. (A) Multiple erythematous papules on the left trunk along the T9 dermatome. (B) Multiple erythematous papules with a keratotic central plug     

播散性带状疱疹一例

患者,女,51岁。左下肢红斑及水疱伴阵发性疼痛20余天,泛发伴发热1周。皮肤科检查：全身散在分布粟粒至黄豆大暗紫红色斑疹、丘疹及丘疱疹,部分融合成片,中央处可见褐色痂皮。细胞涂片可见多核巨细胞及核内包涵体。诊断：播散性带状疱疹。予以甲泼尼龙、更昔洛韦等治疗有效。     

Colonic pseudo-obstruction: a complication of herpes zoster

Summary Herpes zoster has been associated rarely with somatic and visceral motor complications, including segmental motor paralysis, neurogenic bladder dysfunction and. unusually, colonic pseudo-obstruction. We report a patient who developed acute pseudo-obstruction of the colon which followed the appearance of dermatomal herpes zoster.     

Coexistence of psoriasis and linear IgA disease in a patient with recent herpes zoster infection

We report the case of a 29-year-old man with chronic plaque psoriasis who developed linear IgA disease following herpes zoster infection. There has only been one previous report describing the coexistence of psoriasis and linear IgA disease, which was confirmed by immunopathological studies. In our patient, immunoblotting studies identified IgA antibodies binding to BP180 and BP230 antigens, and IgG autoantibodies binding weakly to the BP180 antigen. This is an interesting case that we believe is an example of epitope spreading in the development of autoimmune subepidermal bullous diseases.