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Erschienen in:
01.08.2014 | Images in Infection
A case of erythema multiforme followed by herpes zoster
Erschienen in: Infection | Ausgabe 4/2014
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A 59-year-old man presented with pruritic erythematous to violaceous patches on the whole body that had first appeared 1 week previously. Mucosa was intact and he had no other medical problem including herpes simplex virus (HSV) infection and had not taken any medication for several months. Physical examination revealed typical target lesions, which were symmetrically distributed over the entire body (Fig. 1). Histopathologic findings demonstrated interface dermatitis with dyskeratosis (Fig. 2). With the typical clinical and histopathologic features, erythema multiforme (EM) minor was diagnosed. Painful erythematous grouped vesicles appeared 4 days later on the right T9 and T10 dermatomes (Fig. 3). The serologic test showed positive for varicella-zoster virus (VZV) IgM and IgG which confirm the diagnosis of herpes zoster (HZ). We prescribed intravenous acyclovir in addition to systemic steroid for erythema multiforme, which improved the skin lesion.
Fig. 1
Erythematous to violaceous targetoid annular patch on the trunk
Fig. 2
Histopathologic findings revealed scattered necrotic keratinocytes, lymphocyte exocytosis, mild spongiosis in the epidermis, and inflammatory cell infiltration of the dermo-epidermal junction (H&E, ×200)
Fig. 3
Erythematous grouped vesicles along the right T9 and T10 dermatomes
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