Reacciones granulomatosas secundarias a herpes zóster

Abstract

Abstract—Skin lesions that develop over the sites of resolved herpes zoster are infrequent and diverse. The most frequent ones are granuloma annulare and other types of granulomatous diseases, although others have been described, such as solid malignant tumors, leukemic or lymphomatous infiltrations, infections and comedonic reactions. We review four patients (2 women and 2 men) aged between 34 and 78 years (mean age 61) with granulomatous skin lesions that appeared at the sites of prior herpes zoster. In all of them, a skin biopsy was performed, and the epidemiological, clinical and anatomopathological characteristics were reviewed. The clinical lesions were highly variable, including erythematous papules, depressed scars, infiltrated maculopapular lesions and nodules. In all four cases, the presence of granulomatous infiltration made up of epithelioid-cell granulomas and multinuclear giant cells with no caseous necrosis was observed as a common histological finding. Three of the patients showed a lichenoid infiltrate. There were no signs of herpes infection in the histology.We would like to emphasize the variable clinical presentation of the skin lesions. In the histopathological findings, apart from the granulomatous infiltrate, three patients showed a lichenoid reaction rarely described in literature.