Abstract:
Disseminated cutaneous herpes zoster (DCHZ) is an atypical presentation of herpes zoster (HZ) that mainly affects immunosuppressed patients. Given the potential risk for visceral fatal involvement, prompt recognition of this condition is crucial. In this case report, we present the case of a 90-year-old male with chronic lymphocytic leukemia under chlorambucil treatment who presented to the emergency department with multiple, converging, crusted papules on his face. He was misdiagnosed with a drug eruption and hospitalized after switching the antibiotic therapy. After one week, the lesions spread in a cephalocaudal pattern, affecting both the trunk and limbs, following which the Dermatology team was consulted. We performed an HZV smear test and initiated acyclovir. Unfortunately, the test was positive, and DCHZ was confirmed. The patient died one week later due to pneumonitis which evolved into a severe acute respiratory distress syndrome.
摘要:
播散性皮肤带状疱疹(DCHZ)是带状疱疹(HZ)的非典型表现,主要影响免疫抑制患者。考虑到内脏致命受累的潜在风险,迅速认识到这种情况是至关重要的。在这个案例报告中,我们介绍了一个90岁的男性慢性淋巴细胞白血病的情况下,苯丁酸氮芥治疗谁出现在急诊科与多个,汇聚,他脸上结痂的丘疹。他被误诊为药疹,并在改用抗生素治疗后住院。一周后,病变以头尾模式扩散,影响躯干和四肢,随后咨询了皮肤科团队。我们进行了HZV涂片测试并开始了阿昔洛韦。不幸的是,测试是阳性的,DCHZ得到确认。一周后,患者因肺炎而死亡,肺炎演变成严重的急性呼吸窘迫综合征。