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Updated: Feb 11, 2026

Plaquing of Herpes Simplex Viruses
Published on: November 5, 2021
Postherpetic isotopic responses with 3 simultaneously occurring reactions following herpes zoster
Ashley M Jenkins1, Daniel Skinner2, Jeffrey North3
1Section of Dermatology, University of Chicago Medical Center, Illinois, USA.
Abstract:
Inflammatory, infectious, and neoplastic processes can all occur in prior areas of herpes infection (postherpetic isotopic response [PHIR]). Postzoster granulomatous dermatitis is among the most frequently encountered PHIR, but the exact pathogenesis has not been fully elucidated. Rarely, multiple diseases manifest concurrently in a PHIR. We report a case of cutaneous chronic lymphocytic leukemia (CLL) with an associated granulomatous dermatitis and medium-vessel vasculitis occurring simultaneously at the site of prior herpes zoster. Clinicians and dermatopathologists should be aware of the multiplicity of postzoster isotopic responses and should consider the possibility of multiple diseases manifesting in the same clinical lesion in this setting.
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