Persistent varicella as the initial manifestation of systemic lymphoma

Varicella is a common benign childhood disease that often presents in adolescents and adults in a more severe form. We report a previously healthy 50-year-old man who developed multiple necrotic cutaneous ulcers associated with fever, asthenia and anorexia. Physical examination revealed few tense hemorrhagic vesicles on the trunk and necrotic cutaneous ulcers scattered over the entire cutaneous surface. After the diagnosis of varicella with varicella pneumonia was established, treatment with acyclovir was instituted. His poor response to treatment was indicative of immune compromise; an underlying peripheral T-cell lymphoma was discovered.