Persistent verrucous varicella as the initial manifestation of HIV infection

Clinical presentations of varicella-zoster virus (VZV) infection may vary widely among healthy and immunocompromised patients. In addition, the recurrence of VZV infection with cutaneous manifestations in both of these populations is more common than was once believed. Most cases of verrucous varicella infection have been reported in patients with documented immunosuppression (most commonly HIV/AIDS). We present an unusual case of persistent verrucous varicella, which was the initial manifestation of HIV infection, in a previously "healthy" 3-year-old girl with a strong family history of Wiskott-Aldrich Syndrome. Current research, therapeutic options, and differential diagnoses with regard to VZV infection are briefly reviewed.