Rare sequelae of herpes zoster in HIV positive patient

A 34 year -old woman, who was diagnosed to be HIV positive 4 years back, presented with zoster along T-6 dermatome followed by development of keloid.     

Unusual presentation of herpes zoster in an immunocompromised patient: case report

We present a case of an immunocompromised patient with unusual presentation of herpes zoster infection. After having been treated with corticosteroids for several weeks, the patient developed the zoster infection with atypical clinical course and skin localization. Parenteral treatment with acyclovir for 10 days resulted in a complete clinical resolution of the skin lesions. Similar cases of unusual presentation of herpes zoster have been described in immunocompromised patients.     

Unusual varicella zoster virus infection in a patient with colon carcinoma and Evans syndrome--delayed virus shedding generalized recurrent necrotic herpes zoster

A 53-year-old Japanese woman with Evans syndrome and colon cancer had two episodes of herpes zoster. The first painful vesicular rashes involved the right lower abdomen and buttock and healed in one month. After one more month, a second attack occurred on the right thigh and leg and developed into generalized hemorrhagic lesions, which became crusted in about 90 days. The patient died 131 days after the second attack, when the lesions had almost subsided. Varicella-zoster virus (VZV) was isolated on the 59th day of the second attack. Her intracutaneous reactions to VZV antigen was negative, but the humoral antibodies were continuously positive.     

人免疫缺陷病毒阳性带状疱疹27例临床分析

目的探讨感染人免疫缺陷病毒(HIV)带状疱疹患者的临床特征。方法回顾性分析2013年1月—2014年10月收治的HIV感染并发带状疱疹27例患者临床资料。结果 27例HIV感染者所有疼痛评分均3分(6.07±2.05)分,住院天数为(9.5±2.0)d,均出现了CD4+T淋巴细胞计数降低(343±49)个/μl。结论 HIV感染并发带状疱疹患者与普通带状疱疹患者相比,常常侵犯多神经支配区域,疼痛明显,临床表现更为严重,治疗时间相对较长,CD4+T淋巴细胞计数降低可能是带状疱疹的发生及复发的重要因素。     

Granuloma formation in herpes zoster scars

An 82-year-old male with chronic lymphocytic leukaemia developed an erythematous papular eruption over the trunk. Lesions occurred at the site of scars related to a disseminated herpes zoster infection 3 months previously. Biopsy of a lesion showed granuloma formation. The rash resolved spontaneously over 6-8 weeks.     

HIV prevalence in patients with herpes zoster

To monitor HIV seroprevalence and to determine the sexual risk behaviour of men with herpes zoster (HZ), a study was conducted from Jan 98 to Dec 99 among 115 men of 21 to 55 years of age suffering from HZ. The diagnosis of HZ was clinical and relevant investigations when indicated were carried out to exclude immunodeficiency state. None of the cases were on immunosuppressive drugs. All cases were tested for HIV by immunocomb method and if found positive were confirmed by Western blot assay. Out of 115 cases of HZ 11 (9.5%) were found to be HIV positive. 11 (10.8%) of HIV positive cases were 21-40 years of age. More than one dermatome was involved in 7 (63.6%) HIV positive and in 2 (1.9%) HIV negative cases. 2 HIV positive cases had multiple cranial nerve involvement and one had generalized HZ. None of the cases showed evidence of progression to symptomatic HIV disease. Out of 11 HIV positive cases 9 (81.8%) gave history of multiple unprotected sexual exposures with female commercial sex workers and 2 (18.1%) with amateurs. None of our cases had used condom during sexual intercourse. None gave history of blood transfusion in the past or intravenous drug use.     

Leishmania infection occurring in herpes zoster lesions in an HIV-positive patient

Summary We report the first case of co-infection with herpes zoster and leishmania in the same lesion, on the face of a 29-year-old female, who was an intravenous drug user and who was HIV positive. The infection was initially resistant to acyclovir and itraconazole, and the patient died due to severe infection in the Mediterranean countries is increasing among the HIV-positive population because of the existence of human carriers. Paradoxically, most of these patients show mild forms of visceral leishmaniasis.     

Tumor-like herpes simplex infection in an HIV patient

A 56-year-old male, HIV-positive, presented with a 3-day history of multiple indurated erythematous nodules with superficial and well-defined erosions on his right gluteus. Skin biopsy showed ballooning-necrotic keratinocytes and cultures were positive for herpes simplex 2. Genital herpes simplex infection recurrences may not be restricted to the anterior part of the genitalia and clinical presentation in the lumbar area or gluteus must be differentiated from varicella-zoster virus infection. Tumor-like presentation is a very rare manifestation of HSV cutaneous infection. It is important to take this morphological variant into consideration not to delay the diagnosis of a viral infection, especially in an immunosuppressed patient.     

Atypical herpes zoster in a patient with AIDS

Objective To report a case of persistent infection by varicella-zoster virus (VZV) in an HIV-infected patient who presented with atypical, hyperkeratotic viral lesions and a partial response to acyclovir. Methods Viral changes found on histopathological examination; definitive diagnosis of VZV infection was established by viral culture. Results Lesions of chronic hyperkeratotic herpes zoster responded partially to acyclovir therapy, and complete resolution was achieved with intravenous foscarnet. Absence of visceral involvement. Conclusion Prolonged acyclovir therapy for herpes virus infections in HIV-seropositive patients may represent an important pathogenic factor for the appearance of atypical clinical forms associated with drug-resistant viral strains.     

22例复发性带状疱疹临床分析

[摘要] 目的：了解复发性带状疱疹患者临床特点。方法：回顾性分析22例复发性带状疱疹患者的临床资料。结果：12例初发和复发在同侧发生,6例在同一部位复发,11例初发皮疹和疼痛较复发严重,5例复发症状较初发严重,6例初发和复发症状大致相同。6例合并有肿瘤或其他慢性疾病,1例合并妊娠。15例无合并疾病。结论：22例患者均无严重免疫功能缺陷表现,带状疱疹初发和复发均有劳累或上呼吸道感染等诱因。