Gibney M D, Nahass G T, Leonardi C L
Division of Dermatology, St Louis University Health Sciences Center, Missouri 63104, USA.
Br J Dermatol. 1996 Mar;134(3):504-9.
Three patients, one healthy and two immunocompromised, developed cutaneous reactions that histologically mimicked granuloma annulare at sites of resolved varicella-zoster virus (VZV) reactivation infections. Variable latency periods between the infection and the granulomatous reaction were noted. As in other case reports, the presence of VZV DNA in these lesions was inconsistently demonstrated by the polymerase chain reaction (PCR) and appears more common in early, as opposed to late, post-zoster granulomas. In addition to various granulomatous reactions, vasculitic and neoplastic eruptions following resolved VZV infections have been described and are reviewed here. Therapeutically, topical, intralesional and systemic corticosteroids, as well as acyclovir, have been tried with inconsistent results. Although the pathogenesis remains unclear, the presence of VZV DNA in early lesions that histologically do not display viral cytopathic changes, suggests the virus induces an atypical delayed hypersensitivity reaction not affected by antiviral therapy.
三名患者，一名健康，两名免疫功能低下，在水痘-带状疱疹病毒（VZV）再激活感染消退的部位出现了组织学上类似环状肉芽肿的皮肤反应。观察到感染与肉芽肿反应之间的潜伏期各不相同。与其他病例报告一样，这些病变中VZV DNA的存在通过聚合酶链反应（PCR）的检测结果并不一致，且在带状疱疹后早期肉芽肿中似乎比晚期更常见。除了各种肉芽肿反应外，本文还描述并回顾了VZV感染消退后的血管炎性和肿瘤性皮疹。在治疗方面，已尝试使用外用、皮损内和全身性皮质类固醇以及阿昔洛韦，但结果不一。尽管发病机制尚不清楚，但在组织学上未显示病毒细胞病变变化的早期病变中存在VZV DNA，这表明该病毒会引发一种不受抗病毒治疗影响的非典型迟发型超敏反应。
