title: Case of disseminated vesicles of herpes zoster developing one day before the onset of local eruption in a hospitalized immunocompromised patient.
abstract: Disseminated herpes zoster is not rare in immunocompromised patient. It is defined as at least 20 lesions in multiple dermatomes that occur within a week of the onset of local eruption. Herein, we report that a case of disseminated vesicles of herpes zoster (HZ) that developed one day before the onset of local eruption in an immunocompromised patient. A 44 year-old Japanese male, who had been in the hospital with acute myelocytic leukemia, developed disseminated hemorrhagic vesicles of 5 to 10 mm in diameter. The next day, grouped vesicles, including hemorrhagic vesicles erupted on the right side of the second to third cervical (C2-C3) dermatomes. At this point, the diagnosis was made as disseminated herpes zoster. The activation of varicella-zoster virus (VZV) is believed to be due to waning of VZV-specific memory T cell responses. In our case, the memory immunity to VZV which had been increased by last episode of HZ might affect on the appearance of skin eruptions.
authors.affiliation: Department of Dermatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. mabuchi@is.icc.u-tokai.ac.jp
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Mabuchi
authors.forename: Hanako
authors.initials: H
authors.lastname: Yamaoka
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kato
authors.forename: Norihiro
authors.initials: N
authors.lastname: Ikoma
authors.forename: Shiho
authors.initials: S
authors.lastname: Tamiya
authors.forename: Hae-Jun
authors.initials: HJ
authors.lastname: Song
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Ozawa
mesh_terms: D000328:Adult; D003872:Dermatitis / Q000276:immunology / Q000473:pathology / Q000821:virology*; D006562:Herpes Zoster / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D014645:Herpesvirus 3, Human / Q000502:physiology*; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007156:Immunologic Memory / Q000276:immunology*; D015470:Leukemia, Myeloid, Acute / Q000276:immunology; D008297:Male; D012867:Skin / Q000276:immunology / Q000473:pathology / Q000821:virology; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors; D014775:Virus Activation / Q000276:immunology*