PDF(Pubmed)
Abstract：
Herein, we report the case of a 69-year-old patient who presented to our dermatology clinic for a skin eruption characterized by grouped hemorrhagic vesicles and erosions covered by hemorrhagic crusts on an erythematous background located on the lower right limb. The lesions were small, clustered, and variable in size (diameters between one and 10 mm) and located at the level of the L4-L5 dermatomes. The rash had started three to five days after the complete COVID-19 vaccination scheme with the BNT162b2 Pfizer BioNTech vaccine and had been accompanied by a flu-like syndrome. The histopathological examination established the diagnosis of leukocytoclastic vasculitis potentially in the context of a cytopathic zoster phenomenon. The atypical aspect of the zosterian eruption required additional laboratory work-up to identify possible causes of immunosuppression, i.e., screening for the presence of the human immunodeficiency virus (HIV) infection, solid cancers, as well as measurement of serum immunoglobulin concentrations, which revealed that the subject was HIV-positive. Antiviral treatment was started, with a favorable evolution of the lesions, and the patient was referred to an infectious diseases clinic for initiation of antiretroviral therapy (ART).
摘要：
在这里，我们报告了一例69岁的患者,他因皮肤出疹就诊于我们的皮肤科诊所,其特征是在右下肢红斑背景上出现了一组出血性囊泡和由出血性结皮覆盖的糜烂.病变很小，集群，并且大小可变（直径在1和10毫米之间）并且位于L4-L5皮体的水平。皮疹是在用BNT162b2辉瑞BioNTech疫苗完成COVID-19疫苗接种计划后三到五天开始的，并伴有流感样综合征。组织病理学检查确定了在细胞病变带状疱疹现象的背景下可能诊断为白细胞碎裂性血管炎。带状疱疹喷发的非典型方面需要额外的实验室检查，以确定免疫抑制的可能原因，即，筛查是否存在人类免疫缺陷病毒（HIV）感染，实体癌,以及血清免疫球蛋白浓度的测量，这表明受试者是艾滋病毒阳性。开始抗病毒治疗，随着病变的有利发展，患者被转诊至感染性疾病诊所开始接受抗逆转录病毒治疗(ART).
