Mohan Athira, Suresh Anjana, Sudhesan Athira, Kunjumani Sobhanakumari, Celine M I
Department of Dermatology, Government T. D. Medical College, Alappuzha, Kerala, India.
Indian J Dermatol Venereol Leprol. 2022 Nov-Dec;88(6):771-773. doi: 10.25259/IJDVL_65_20.
Varicella gangrenosa is a rare but life-threatening dermatological complication of infection with varicella-zoster virus. A healthy 37-year-old male who had been diagnosed with varicella 20 days back was admitted to our hospital with complaints of fever and painful necrotic skin lesions. Physical examination revealed multiple round to oval ulcers covered with eschar predominantly over arms, lower limbs, back of trunk and flanks. Streptococcus pyogenes and Staphylococcus aureus grew in wound culture. Biopsy revealed ulceration and necrosis of epidermis, and edema, hemorrhage and granulation tissue formation involving the dermis and subcutaneous tissue. The patient was treated with acyclovir - parenteral followed by oral, antibiotics and supportive measures. The lesions healed and he was discharged after 20 days. We report this case to draw attention to the fact that varicella gangrenosum, even though a rare complication, may occur in the lesions of chicken pox and that the survival of patient depends on early diagnosis and aggressive treatment.
坏疽性水痘是水痘-带状疱疹病毒感染罕见但危及生命的皮肤并发症。一名20天前被诊断为水痘的37岁健康男性因发热和疼痛性坏死性皮肤病变入院。体格检查发现多个圆形至椭圆形溃疡,主要分布在手臂、下肢、躯干背部和侧腹,表面覆盖有焦痂。伤口培养分离出化脓性链球菌和金黄色葡萄球菌。活检显示表皮溃疡和坏死,真皮和皮下组织出现水肿、出血和肉芽组织形成。患者接受了阿昔洛韦治疗(先静脉注射后口服)、抗生素治疗及支持治疗。病变愈合,20天后出院。我们报告此病例以引起注意,即坏疽性水痘虽是罕见并发症,但可发生于水痘病变中,且患者的存活取决于早期诊断和积极治疗。