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Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
Published on: July 9, 2014
Occult varicella.
Arjen F Nikkels1, Gérald E Piérard
1Department of Dermatology, CHU du Sart Tilman, Liège, Belgium. af.nikkels@chu.ulg.ac.be
The Pediatric Infectious Disease Journal
|November 26, 2009
Summary
Varicella zoster virus (VZV) infection can manifest as localized skin lesions on pre-existing dermatitis, mimicking other conditions. Early detection through viral testing is crucial for accurate diagnosis and management of this rare presentation.
Area of Science:
- Dermatology
- Virology
- Pediatric Infectious Diseases
Background:
- Localized varicella (chickenpox) is typically linked to UV exposure or skin trauma.
- Varicella infection restricted to pre-existing dermatitis is an uncommon clinical presentation.
Purpose of the Study:
- To present the clinical, cytohistologic, immunohistochemical, and serologic findings of six patients.
- To describe a rare presentation of varicella zoster virus (VZV) infection localized to pre-existing dermatitis.
Main Methods:
- Analysis of clinical features, Tzanck smears, skin biopsy, and immunohistochemistry for herpes simplex virus (HSV) and VZV.
- Serologic testing including VZV-specific IgM and IgG via enzyme immunoassay (EIA) and complement fixation test.
- Clinical follow-up to assess disease progression and resolution.
Main Results:
- Six pediatric patients (mean age 8.3 years) presented with vesicular lesions on various pre-existing dermatoses.
- Tzanck smears and biopsy showed multinucleated giant cells; immunohistochemistry confirmed VZV infection.
- Serology indicated primary VZV infection, with localized lesions resolving without antiviral treatment.
Conclusions:
- Varicella infection can remain localized within pre-existing dermatitis, presenting atypically without widespread chickenpox symptoms.
- The sudden onset of vesicular or ulcerated lesions on dermatitis warrants investigation for underlying viral infections like VZV.
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