Fernandes Neil F, Malliah Rajit, Stitik Todd P, Rozdeba P, Lambert W Clark, Schwartz Robert A
Pathology, and Physical Medicine and Rehabilitation, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA.
Acta Dermatovenerol Alp Pannonica Adriat. 2009 Mar;18(1):28-30.
Localized herpes zoster following intra-articular corticosteroid injection is remarkable. We describe an 80-year-old woman with severe osteoarthritis that received an intra-articular injection of 80 mg methylprednisolone in her knee, followed 1 day later by the appearance of linear unilateral vesicles and bullae on her leg in a dermatomal distribution adjacent to the injection site. The roofs of several blisters showed classic viral cytopathic effects for herpes including keratinocytes with multinucleation and margination of chromatin. Varicella zoster virus immunostaining revealed positive staining in the keratinocytes. One plausible explanation is herpes zoster virus reactivation secondary to localized immunosuppression from corticosteroid injection.
关节腔内注射皮质类固醇后出现的局限性带状疱疹值得关注。我们描述了一位80岁患有严重骨关节炎的女性，她接受了膝关节内80毫克甲泼尼龙的注射，1天后在其腿部注射部位附近出现了沿皮节分布的单侧线性水疱和大疱。几个水疱的疱顶显示出典型的疱疹病毒细胞病变效应，包括多核角质形成细胞和染色质边缘化。水痘带状疱疹病毒免疫染色显示角质形成细胞呈阳性染色。一种合理的解释是，皮质类固醇注射导致局部免疫抑制继发带状疱疹病毒再激活。
