Varicella-like infection due to herpes simplex

Area of Science:

• Dermatology
• Virology
• Immunology

Background:

• Herpes simplex virus (HSV) typically causes localized skin lesions.
• A varicella-like eruption is an uncommon but significant HSV presentation.
• Differential diagnosis from chickenpox is crucial for appropriate management.

Observation:

• A patient with systemic lupus erythematosus on prednisone presented with a varicella-like rash.
• Seven additional cases of varicella-like HSV infections were identified in the literature.
• These cases involved patients with varying degrees of immunosuppression.

Findings:

• Immunosuppression, including systemic lupus erythematosus and corticosteroid therapy, is a key factor in varicella-like HSV eruptions.
• Varicella-like herpes simplex can mimic varicella (chickenpox) clinically.
• Prompt recognition and treatment are essential to prevent complications.

Implications:

• Clinicians should consider herpes simplex in the differential diagnosis of varicella-like eruptions, particularly in immunocompromised patients.
• Understanding the role of immunosuppression in HSV infections is vital for patient care.
• This presentation underscores the importance of a thorough diagnostic workup for atypical herpetic infections.