A man in his 50s with a several-year history of biopsy-proven of Darier disease who
was treated irregularly with acitretin and prophylactic oral acyclovir started after
a previous superimposed herpes simplex virus (HSV) infection presented with complaints
of worsening skin lesions and subacute increase of tenderness on his back, arms, and
hands for the last two weeks. On physical examination, there were numerous red-brown
hyperkeratotic hyperpigmented papules and macules and numerous vesicles on his face,
trunk, back, arms, hands, and inguinal folds affecting more than 50% of his total
body surface area (TBSA) (Figure 1A-C). Serum lgG levels were positive for both HSV-1 and -2 indicating a previous infection.
He has been diagnosed with Kaposi varicelliform eruption induced by disseminated HSV1.
He was started on a high dose of intravenous (IV) acyclovir (10 mg/kg/dose) every
8 hours for 10 days with gradual improvement of his eruption. He was discharged on
chronic suppressive acyclovir at an oral dose of 400 mg twice daily and will be followed
up as an outpatient for further treatment of Darier disease and recurrent infections.
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References
- Darier disease.J Dermatol. 2016; 43: 275-279
- Role of pro-inflammatory cytokines in the pathophysiology of herpes simplex virus superinfection in Darier's disease.J Dermatol. 2021; 48: 1607-1611
- Darier disease with disseminated herpes simplex virus type 2 infection.Dermatol Online J. 2019; 25
- Kaposi's varicelliform eruption: a case series.Indian Dermatol Online J. 2015; 6: 399
- Kaposi varicelliform eruption in patients with autoimmune bullous dermatoses.Int J Dermatol. 2016; 55: e136-e140
- Kaposi varicelliform eruption in a patient with pemphigus vulgaris: a case report and review of the literature.Case Rep Dermatol Med. 2020; : 2020
Article info
Publication history
Published online: February 09, 2023
Accepted:
February 6,
2023
Received:
November 3,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
