Image Gallery / Spot Diagnosis
 
Dermatomal Skin Rash and Generalized Rash
Question :
Malika Bharadwaj
Surya Children hospital, Mumbai, India

Address for Correspondence: Dr Malika Bharadwaj, Mangal Ashirwad, Junction of S.V road and Dattatray Road, Santa Cruz{W}, Mumbai 400053. Email: malikaminocha@yahoo.com

A 7 years old male child presented with maculopapular lesions of on the trunk and papulovesicular lesions on the left arm involving left C5 ,C6 dermatomes which appeared simultaneously the day before the visit. There was no history of chronic diseases. The child had received primary immunization but not the optional vaccines. On physical examination, no abnormal findings other than the skin lesions were seen. Laboratory tests including complete blood count, liver function test, BUN, serum creatinine, HIV screening test were all normal.

What is the diagnosis_?
 
Answer :
Concurrent appearance of herpes zoster and varicella. It is rare and has been reported in immunocompromised patients, probably because these patients are predisposed to infection and because the clinical features in immunocompromised patients are more severe and extensive. The child was started on oral Acyclovir at 20mg per kg bodyweight 4 times a day given for 5 days. On follow up after 7 days, both groups of lesions resolved completely following the treatment.

E-published: September 2012 Vol 9 Issue 9 Art No. 60

DOI No. : 10.7199/ped.oncall.2012.60