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Kaposi varicelliform eruption due to disseminated herpes simplex in a patient with known Darier disease

Published:February 09, 2023DOI:
      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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