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Am J Dermatopathol. 2018 Dec;40(12):920-923. doi: 10.1097/DAD.0000000000001264.

Atypical Varicella-Zoster Kaposi Varicelliform Eruption in Sézary Syndrome.

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Zucker School of Medicine at Hofstra/Northwell, Department of Dermatology, Lake Success, NY.
Ackerman Academy of Dermatopathology, New York, NY.
Dermatology and Cosmetic Medicine Specialists, Chester, NJ.
Summit Medical Group, Morristown, NJ.


Patients with mycosis fungoides experience considerable morbidity and mortality from secondary bacterial and viral infections. Staphylococcus aureus, β-hemolytic streptococci, herpes simplex virus, and herpes zoster virus remain the most common infectious pathogens in this group of patients. With depressed cellular immunity and diminished skin barrier as the main precipitating risk factors, immunocompromised patients can often present with an atypical presentation of a common dermatologic condition. The case herein discusses a clinically atypical nonvesicular Kaposi varicelliform eruption secondary to a varicella-zoster virus in a patient with Sézary syndrome. Concurrent polypharmacy in these patients is also a risk factor for development of drug hypersensitivity reactions. However, given their immunocompromised status, first and foremost, a careful inspection should be made of every atypical skin eruption in search of an infectious etiology, and afterward, an appropriate treatment should be promptly initiated.

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