Kaposi's Varicelliform Research Articles

Kaposi’s Varicelliform Eruption in a Patient with Darier’s Disease: A Rare Case Report

Darier's disease is a rare autosomal dominant disorder, characterized clinically by the appearance of multiple, pruritic, discrete, and scaly papules affecting seborrheic areas coupled with palmar pits, nail changes, and mucosal involvement. Histologically, the lesions show supra-basal clefts with acantholytic and dyskeratotic cells. Kaposi's varicelliform eruption (KVE) is the dissemination of the herpes simplex virus in the setting of preexisting skin disease, presenting with disseminated vesico-pustules. Darier's disease presenting as KVE is a rare occurrence. If misdiagnosed or left untreated can increase the rate of mortality. Here, we report the case of a 25-year-old male patient who presented with multiple vesicles and crusted lesions over the face, neck, chest, and upper back. After thorough cutaneous examination, he was found to have multiple hyperkeratotic, dirty-warty papules over seborrheic areas, present since childhood. With detailed clinical and laboratory evaluation, we arrived at the diagnosis of KVE with underlying Darier disease.

Kaposi's Varicelliform Eruption: A Potentially Life-Threatening Complication of Atopic Dermatitis.

Kaposi's varicelliform eruption (KVE), also known as eczema herpeticum or eczema vaccinatum, is an acute dermatosis that affects patients with chronic dermatopathies. The diagnosis is primarily clinical and is characterised by the presence of a vesicular exanthema on physical examination. The exanthema subsequently evolves into crusted lesions with typical circular ulcerations in 'punched-out' areas on the skin affected by the underlying dermatopathy. We present the case of a 6-year-old patient who presented to the Paediatric Emergency department with skin lesions consistent with eczema herpeticum. The patient's management was initially outpatient; however, due to the slow progression of the condition, hospitalisation and intravenous antiviral treatment were initiated. KVE affects patients with chronic dermatoses, especially atopic dermatitis. It is important to know the clinical presentation for an early suspicion. KVE is a medical emergency that requires prompt diagnosis and treatment. It can progress to secondary viraemia, which can be fatal in up to 10% of immunocompetent individuals and up to 50% of immunocompromised individuals. It is important to be aware of this condition and to start early treatment with antivirals, especially given the high prevalence of atopic dermatitis in our population. This condition is one of the most serious complications that can occur in these patients. To facilitate early suspicion and diagnosis, disseminate information about eczema vaccinatum.Emphasise the importance of initiating antiviral treatment early to prevent potential complications of eczema herpeticum.If left untreated, Kaposi's varicelliform eruption can result in up to a 10% mortality rate in immunocompetent individuals and a 50% mortality rate in those who are immunocompromised.

Th1 regulatory events by infectious pathogens, herpes zoster and herpes simplex viruses: prospects for therapeutic options for atopic eczema.

Infections caused by viral and bacterial pathogens are typically perceived as harmful, such as in cases of herpes zoster and herpes simplex virus infections. However, clinical observation of an improvement in atopic skin lesions upon herpes virus infection has been noted, particularly at the site of varicella and Kaposi’s varicelliform eruption. Th1 immune cells and cytokines, mobilized and induced for protection against infectious pathogens, are expected to improve Th2 dominant atopic symptoms. This study focuses on Th1 immunoregulatory events mediated by infectious pathogens, particularly herpes viruses. Immunoregulatory events induced by herpes viruses may have a potential therapeutic value for treating atopic eczema.

Наблюдение коморбидности синдрома Марфана с тяжелым атопическим дерматитом: необходимость ранней диагностики и лечения пациентов с аллергодерматозами в детском возрасте

We report a case of a rare combination of Marfan syndrome and severe atopic dermatitis (AD) in a 32-year-old male patient. He developed AD in early childhood and then had a relapse at the age of 18 years caused by stress. After this, AD became severe due to stress associated with aortic aneurysmectomy. The patient also had side effects caused by steroids, including multiple pustular eruptions, Kaposi's varicelliform eruption, edema and hyperemia of the periorbital area, pain and swelling of the small joints of the hands. These side effects, as well as specific cardiovascular symptoms typical of Marfan syndrome necessitated the search for alternative treatment strategies for severe AD. Eventually, we managed to find an effective treatment regimen that caused no side effects or adverse events, while the symptoms subsided. This case demonstrates the importance of early AD diagnosis in childhood in order to prevent its transition into severe chronic form that can hardly be managed in adulthood. Key words: atopic dermatitis, children, diagnostic criteria, clinical manifestations, hereditary diseases, Marfan syndrome

Sistemik Steroid Tedavisi Alan Tinealı Bir Hastada Görülen Kaposi'nin Variselliform Döküntüsü

Sistemik Steroid Tedavisi Alan Tinealı Bir Hastada Görülen Kaposi'nin Variselliform Döküntüsü

Kaposi's varicelliform eruption after chemotherapy

Kaposi's varicelliform eruption after chemotherapy

Severe Kaposi's varicelliform eruption in mild atopic dermatitis complicated by rhabdomyolysis: A case report

Severe Kaposi's varicelliform eruption in mild atopic dermatitis complicated by rhabdomyolysis: A case report

“Localized” Kaposi's varicelliform eruption caused by varicella zoster virus in a patient of irritant dermatitis

Kaposi's varicelliform eruption (KVE) refers to disseminated viral infections due to herpes simplex, coxsackie A16, etc., in patients of preexisting skin disease. Localized forms of KVE are less well characterized. We hereby describe localized eruption of KVE caused by varicella zoster virus in a patient of irritant dermatitis.

Kaposi's Varicelliform Eruption in a Patient with Darier's Disease.

Kaposi's Varicelliform Eruption in a Patient with Darier's Disease.

A case of pemphigus foliaceus complicated by adult Kaposi's varicelliform eruption

A case of pemphigus foliaceus complicated by adult Kaposi's varicelliform eruption

Pemphigus foliaceus complicated by Kaposi varicelliform eruption and bilateral herpes simplex keratitis

Abstract Pemphigus foliaceus (PF) is a chronic autoimmune blistering dermatosis (ABD) that often involves the face, scalp and trunk. Kaposi's varicelliform eruption (KVE) is a viral vesicular dermatosis that rarely complicates ABD. In addition, KVE infrequently causes ocular involvement including herpes simplex keratitis (HSK). Timely diagnosis of KVE may be difficult in patients with PF due to their overlapping clinical features. In this report, we described a 79-year-old female with PF complicated by KVE and bilateral HSK. This report reminds physicians that KVE should be considered in patients with refractory PF and other ABD.

Kaposi's Varicelliform Eruption in Phenytoin-Induced Erythroderma.

Kaposi's Varicelliform Eruption in Phenytoin-Induced Erythroderma.

Why is it So Important to Recognize Kaposi's Varicelliform Eruption Early?

Why is it So Important to Recognize Kaposi's Varicelliform Eruption Early?

A rare complication of follicular hair unit extraction: Kaposi's varicelliform eruption.

Follicular hair unit extraction (FUE) is becoming a popular type of hair transplantation recently. Kaposi’s varicelliform eruption (KVE) is an uncommon skin emergency due to cutaneous dissemination of several types of viruses, most notably herpes virus, over the lesions of preexisting skin disorders.A 34-year-old man visited our dermatology outpatient clinic with a blistering, itchy and tender eruption on his head and body. He had undergone follicular FUE for androgenic alopecia 12 days previously, and 5 days after the procedure, umbilicated and/or hemorrhagic vesiculopustules appeared firstly on the occipital scalp skin where the hair units were taken. The lesions had rapidly spread over the upper chest and back. After the operation, he had taken oral methylprednisolone, amoxicillin clavulanate and had used fusidic acid ointment without any benefit. Bacterial culture of the pustules yielded no microorganism, while Tzanck smear from the vesicles revealed multinuclear giant cell groups. Based on a diagnosis of KVE, we treated the patient with oral valacyclovir hydrochloride 1000 mg 3 times a day for 14 days. Symptoms cleared rapidly, pustules and vesicles dried in a few days, and re-epithelialization of the eroded areas started at the end of the first week.The reported complications of FUE include necrosis of the donor site, postoperative hyperesthesia, recipient area folliculitis, keloids, bleeding, infection and pyogenic granuloma. Up to this date there are only three reports of KVE developing just after dermatological surgery, including dermabrasion, laser resurfacing, and skin grafting. According to our knowledge, this is the first case of KVE occurring after the FUE procedure. We think that the traumatic effects and skin barrier disruption due to operation and immune alteration due to postsurgical steroid treatment might have precipitated the activation and dissemination of latent herpesvirus infection.

A Case of Endothelial Keratitis Associated with Immunosuppressant in Kaposi's Varicelliform Eruption

Purpose: To report a case of endothelial keratitis occurred after reactivation of herpes simplex virus following immunosuppressant therapy for Kaposi’s varicelliform eruption. Case summary: A 23-year-old female was referred for ocular pain and blurred vision. She had atopic dermatitis and was diagnosed with Kaposi’s varicelliform eruption on her face after using an immunosuppressant. Slit lamp examination revealed central corneal edema in the right eye. She was initially diagnosed with contact lens-induced keratitis. Subsequently, the contact lens was removed and topical antiviral agent used for prevention of ocular involvement. Four days after treatment, Wesseley immune ring of deep stromal haze and cells in the anterior chamber were present. She was diagnosed with endothelial keratitis caused by reactivation of herpes simplex virus after using an immunosuppressant. Topical steroid, hypertonic saline eye drops and cycloplegic eye drops were added to the treatment for the progression of endothelial keratitis. Corneal edema was decreased 2 weeks after treatment and anterior chamber cells decreased 1 month after treatment. There was no recurrence during the follow-up period. Conclusions: Patients diagnosed with Kaposi’s varicelliform eruption after using immunosuppressants should have an ophthalmic examination to confirm ocular involvement; use of appropriate eye drops is necessary for the treatment of corneal involvement. J Korean Ophthalmol Soc 2016;57(10):1640-1644

カポジ水痘様発疹症患者に対するファムシクロビル（ファムビル®錠250mg）の有効性および安全性の検討（特定使用成績調査）

カポジ水痘様発疹症患者に対するファムシクロビル（ファムビル®錠250mg）の有効性および安全性の検討（特定使用成績調査）

Increased large unstained cells value in varicella patients: A valuable parameter to aid rapid diagnosis of varicella infection.

Varicella is a highly contagious infection caused by varicella zoster virus. Sometimes it is difficult to differentiate between other viral infections such as Kaposi's varicelliform eruption (KVE) and disseminated herpes zoster (HZ). The large unstained cells (LUC) value is a differential count parameter reported by routing hematology analysis. LUC have been studied previously, but never been reported in the context of varicella or in dermatological published work. The aim of this study was to compare the LUC values in varicella patients with that in KVE and disseminated HZ patients. Sixty-nine varicella patients, 30 KVE patients and 11 disseminated HZ patients were included in this retrospective study. All data were analyzed using SPSS version 17.0 or GraphPad Prism version 5.0. The mean percentage of LUC (%LUC) in varicella patients was higher than the upper limit of normal reference range and it was increased compared to %LUC of both KVE (P<0.0001) and disseminated HZ (P=0.0051) patients. %LUC of varicella patients significantly decreased with clinical improvements (P=0.0017). %LUC was significantly increased in varicella patients and corresponded with clinical improvements. Patients with %LUC of 3.55 or more favor the diagnosis of varicella over both KVE and disseminated HZ with 71.01% sensitivity and 84.44% specificity. We suggest that %LUC can assist in making a precise diagnosis of varicella in confusing cases.

A Case of Kaposi's Varicelliform Eruption in a Patient with Psoriasis Receiving Cyclosporine Therapy.

Dear Editor: Kaposi's varicelliform eruption (KVE) is a disseminated cutaneous infection caused by several viruses such as herpes simplex virus (HSV) type 1 and 2, and coxsackievirus A16 in patients with an underlying dermatosis. The term eczema is used when the pathogenic virus is HSV1 or HSV2. KVE may rarely occur in patients with psoriasis; refers to the occurrence of KVE in psoriasis patients1,2. Here, we report the case of patient with erythrodermic psoriasis who developed KVE while receiving cyclosporine therapy. A 53-year-old male with a 30-year history of psoriasis vulgaris was admitted to our inpatient clinic with erythroderma starting 2 weeks earlier. Treatment with 4.5 mg·kg-1·day-1 cyclosporine A was initiated. On the 7th day of hospitalization, the patient developed vesicles and vesiculopustules all over the face, trunk, and extremities that progressed to papules with hemorrhagic crusts (Fig. 1, ​,2).2). A diagnosis of KVE was considered, and polymerase chain reaction (PCR) examination for HSV1 and HSV2 was performed; the result was positive for HSV1 infection. Bacterial culture from the lesions revealed no bacterial growth. Ocular investigation did not reveal a herpetic infection. Routine investigations including complete blood count, liver and renal function tests, and chest X-ray were normal. Therapy with intravenous acyclovir 10 mg/kg thrice daily was initiated and administered for 1 week. The lesions regressed completely within 10 days. Fig. 1 Hemorrhagic crusted papules on the face. Fig. 2 Hemorrhagic crusted papules, pustules, and vesicles on the trunk. KVE is a potentially life-threatening viral infection that arises in pre-existing skin conditions3. Although majority of the cases occur in patients with atopic dermatitis, it has also been reported in other various diseases such as Darier's disease, Grover's disease, pemphigus foliaceus, and ichthyosis vulgaris1,2,3. However, KVE developing in a patient with psoriatic erythroderma is very rare1,2,3,4,5 (Table 1). Table 1 Reported cases of psoriasis herpeticum Although the exact pathogenesis of KVE is unclear, increased susceptibility to infections due to altered host defense and impaired skin barrier function are implicated1. Our patient had a compromised cutaneous barrier due to erythrodermic psoriasis. Furthermore, he was receiving systemic cyclosporine therapy, which might have predisposed him to the development of KVE owing to the drug's immunosuppressive effect. Clinically, KVE presents as clusters of umbilicated vesicles that may transform into pustules or painful hemorrhagic crusted erosions on the skin affected by the pre-existing dermatosis2,3. This may be accompanied by fever, malaise, and lymphadenopathy2,4. Ocular involvement may be observed; and ophthalmology consultation should be performed immediately upon suspicion2. The diagnosis of KVE is made clinically and can be confirmed by PCR for viral DNA or viral culture; electron microscopy and immunofluorescence testing can also be used1,2. As systemic viremia with multiorgan involvement may cause morbidity and mortality in such patients, rapid diagnosis and antiviral therapy are important4. In summary, although rare, the diagnosis of psoriasis herpeticum should be kept in mind in psoriasis patients presenting with vesicular/vesiculopustular lesions.

Kaposi'nin Variselliform Erüpsiyonu ile Komplike Olmuş Bir Darier Hastalığı Olgusu

Darier's disease (DD) is a rare genodermatosis of autosomal-dominant inheritance which is characterized by flesh-colored to brownish hyperkeratotic papules and plaques with a greasy and warty texture. DD runs a life-long course with exacerbations and remissions. Despite the assumed benign nature of the disease, DD has been linked to a variety of other diseases and complications. Kaposi's varicelliform eruption (KVE) is a disseminated cutaneous infection which is generally caused by herpes simplex virus in the setting of underlying primary dermatosis such as atopic dermatitis, pemphigus vulgaris, psoriasis, contact dermatitis, and DD. Here we report a case of DD which is complicated with KVE.

Kaposi′s varicelliform eruption: A case series

Kaposi's varicelliform eruption is a rare and potentially fatal viral infection caused mainly by reactivation of herpes simplex virus. It concomitantly occurs with pre-existing skin conditions, mostly atopic dermatitis, so it is predominately found in children. We present a case series that includes four adults, familial cases, and previously healthy patients. We also highlight clinical features, associations and therapeutic options.