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Chickenpox: an ageless disease.

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A 97-year-old woman with a vesicular rash was initially misdiagnosed. Varicella zoster virus (VZV) infection was later confirmed, leading to appropriate antiviral treatment.

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Area of Science:

  • Geriatric Medicine
  • Infectious Diseases
  • Dermatology

Background:

  • Vesicular rashes in the elderly can present diagnostic challenges.
  • Early recognition of viral infections is crucial for timely management.
  • Differential diagnoses for vesicular eruptions include autoimmune and infectious conditions.

Observation:

  • A 97-year-old female presented with a rapidly progressing vesicular rash affecting the lower extremities, trunk, and abdomen.
  • Initial management focused on bullous pemphigus with high-dose steroids.
  • The rash distribution and progression prompted reconsideration of the diagnosis.

Findings:

  • Varicella zoster virus (VZV) infection was clinically suspected and subsequently confirmed by VZV DNA swabs.
  • The patient's presentation mimicked other blistering skin conditions, highlighting diagnostic complexities.
  • Delayed diagnosis potentially led to prolonged exposure to an incorrect treatment regimen.

Implications:

  • This case underscores the importance of considering VZV in elderly patients with vesicular eruptions.
  • Prompt diagnosis and initiation of antiviral therapy (acyclovir) are essential for managing VZV.
  • Misdiagnosis can lead to inappropriate treatments and delayed recovery in geriatric patients.