Zosteriform Distribution Research Articles

Segmental scarring following intrauterine herpes simplex virus infection

We report the case of a female infant with an intrauterine herpes simplex type II infection in zosteriform distribution. She was treated with several courses of intravenous acyclovir leading to healing of the skin with segmental scarring. This patient is unusual in that the infection occurred in zosteriform distribution without any evidence of systemic involvement.

MULTIPLE ANGIOKERATOMAS WITH ZOSTERIFORM DISTRIBUTION IN TWO SISTERS

Case 1: At the age of 12 years a 28 year‐old woman noticed multiple reddish papular lesions on the left buttock and thigh. The lesions gradually spread to involve her left thigh towards the knee. The patient had no systemic symptoms, Examination of the skin revealed 23 well‐circumscribed, purplish verrucous lesions each of 2–3 mm diameter, located over the left buttock and extending in a linear fashion to the popliteal flexure (Fig. 1). General examination and routine laboratory studies were normal. Case 2: A 27‐year‐old woman, sister of the previous patient, noticed at the age of 10 years a steadily increasing number of purple lesions on her left buttock that gradually extended to the left posterior thigh. The lesions were asymptomatic, although the patient noticed occasional bleeding with trauma. The lesions of the thigh had disappeared spontaneously without scarring during the previous 4 years. When we first examined this patient, at the age of 27, she had eight reddish papular hyperkeratotic lesions, 2–3 mm in size, with a linear zosteriform distribution over the left buttock. She was healthy and symptom free. Routine laboratory studies were normal.An excision biopsy was taken from each sister. The histopathologic examination revealed similar findings in both lesions. Hyperkeratosis with slight acanthosis and papillomatosis was present. Greatly dilated capillaries were seen in the upper and middermis. The capillary walls were lined by flattened endothelium. In one area of the lesion from the second patient there was intravascular thombosis (Fig. 2).

Progressive Cribriform and Zosteriform Hyperpigmentation

Five cases of progressive cribriform and zosteriform hyperpigmentation are described. The following criteria were fulfilled: (1) uniformly tan cribriform macular pigmentation in a zosteriform distribution; (2) a histologic pattern that consisted of a mild increase in melanin pigment in the basal cell layer and complete absence of nevus cells; (3) no history of rash, injury, or inflammation to suggest postinflammatory hyperpigmentation; (4) onset well after birth with gradual extension; and (5) lack of other associated cutaneous or internal abnormalities. This appears to be a newly described entity, although it resembles a Becker's nevus without hypertrichosis or an typical café au lait spot. We believe that such progressive cribriform and zosteriform pigmentation is not uncommon.

Zosteriform Porokeratosis of Mibelli

Porokeratosis of Mibelli in a zosteriform distribution occurred in two girls. Although this has been previously described, the true incidence is not known. The diagnosis is most confused with lichen striatus, keratosis follicularis, nevus unius lateris, or other epidermal nevi.

Carcinoma of the Prostate with Zosteriform Cutaneous Lesions

Cutaneous manifestations associated with visceral carcinoma are not common. The recorded statistics of this occurrence vary from 2.7% to 4.4%. Carcinoma of the prostate rarely metastasizes to the skin. Our two patients, who had carcinoma of the prostate, developed cutaneous metastasis which occurred in a zosteriform distribution. In a series of 2031 autopsies of various types of carcinoma, Gates 9 found cutaneous metastases occurred in 58 cases in which there was internal organ involvement; an incidence of 2.8%. There was only one case of carcinoma of the prostate associated with cutaneous lesions in this series of cases. Four patients having cutaneous involvement associated with carcinoma of the prostate were mentioned by Arnheim, 2 while Barenghi 4 and Huggins 10 each reported one case. A patient who had carcinoma of the prostate with metastases to the scalp which simulated turban tumors was described by Ronchese. 20 Only one