Varicella zoster virus infection associated with erythema multiforme in children.
BACKGROUND
Erythema multiforme (EM) is a vesiculobullous disorder with variable manifestations which predominantly affects the skin. It is regarded as a hypersensitivity disorder which is triggered by multiple factors such as infection, drugs and food. Varicella zoster virus (VZV) has rarely been reported as an etiological agent, despite its high incidence as a pathogen in childhood.


METHODS
We describe two children in whom EM preceded VZV infection. In the first, a 5-year-old boy, EM was followed 3 days later by a classical disseminated varicella eruption. The diagnosis was reached by clinical, epidemiological and serological means. The second patient was a 13-year-old boy with EM which was followed 2 weeks later by Ramsay-Hunt syndrome. The diagnosis was confirmed by skin biopsy, positive serology and viral culture.


CONCLUSIONS
The association of EM and VZV infection is probably more common than reported. In clinical cases of EM, VZV should be included in the list of possible causative agents.
Dept. of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tiqva. daprais@hotmail.com
D
D
Prais
G
G
Grisuru-Soen
A
A
Barzilai
J
J
Amir
D000293:Adolescent; D002675:Child, Preschool; D004892:Erythema Multiforme / Q000209:etiology*; D006562:Herpes Zoster / Q000150:complications* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000209:etiology; D012867:Skin / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000209:etiology