Atypical varicella/zoster infection in AIDS.

Abstract

A case of atypical varicella zoster in a 33/year/old AIDS patient is reported. The patient had had two attacks of herpes zoster within a year and was given high/dose acyclovir several times. Thereafter he developed small keratotic pellucid papules on fingers, wrists and face, which were found to contain varicella/zoster antigen by the ELISA test. Skin biopsy showed acanthosis and lack of vesication, as is usually seen in herpes infections. The atypical varicella/like lesions persisted despite repeated doses of acyclovir but cleared temporarily when the patient was given foscarnet. We believe that the prolonged therapy may have allowed selection of acyclovir/resistant varicella/zoster strains, resulting in the atypical clinical course.