Introduction. Chickenpox is a varicella zoster virus (VZV) induced disease characterized by many following crops of vescico-pustules on the skin surface. In a very few cases chickenpox starts with tense, clear, bullous lesions evolving into pustules after some days. Case report. A 28-year old young lady, suffering from atopy, returned from holiday at the seaside to our Department because of the onset, a week before, of many erythematous-bullous clear, tense lesions, 5-6 mm in diameter localized on the face and the trunk. The lesions affected only photoexposed skin and spared areas previously photoprotected by the swim suit. A few days after our first examination, bullae evolved into pustules. The clinical diagnosis of chickenpox was confirmed with a biopsy, the positive results of the viral culture and with seroconversion. The patient was successfully treated with acyclovir 4 gr daily for 10 days. Discussion. Bullous onset of chickenpox is very rare and it may be due to a more virulent strain of virus or to an impaired immunologic reactivity of the patient. In our case the condition of atopy might have played a significant role; the localization of the lesions to photoexposed areas is probably related to an UV induced skin immunosuppression (the patient was sunbathing all day long) that influenced the clinical picture.
Bullous chickenpox limited to the photoexposed skin. Case report [VARICELLA BOLLOSA FOTOCONDIZIONATA. CASO CLINICO]
TESSARI, Gianpaolo;BARBA, Annalisa;CHIEREGATO, CARLO;SCHENA, DONATELLA
1996
Abstract
Introduction. Chickenpox is a varicella zoster virus (VZV) induced disease characterized by many following crops of vescico-pustules on the skin surface. In a very few cases chickenpox starts with tense, clear, bullous lesions evolving into pustules after some days. Case report. A 28-year old young lady, suffering from atopy, returned from holiday at the seaside to our Department because of the onset, a week before, of many erythematous-bullous clear, tense lesions, 5-6 mm in diameter localized on the face and the trunk. The lesions affected only photoexposed skin and spared areas previously photoprotected by the swim suit. A few days after our first examination, bullae evolved into pustules. The clinical diagnosis of chickenpox was confirmed with a biopsy, the positive results of the viral culture and with seroconversion. The patient was successfully treated with acyclovir 4 gr daily for 10 days. Discussion. Bullous onset of chickenpox is very rare and it may be due to a more virulent strain of virus or to an impaired immunologic reactivity of the patient. In our case the condition of atopy might have played a significant role; the localization of the lesions to photoexposed areas is probably related to an UV induced skin immunosuppression (the patient was sunbathing all day long) that influenced the clinical picture.
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