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Varicella zoster virus brachioplexitis associated with granulomatous vasculopathy.
MedLine Citation:
PMID:  23621091     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Varicella zoster virus (VZV) causes the common childhood isease chickenpox (varicella), or upon reactivation, the dermatomal vesiculopustular eruption seen in shingles (herpes zoster). The clinical course of herpes zoster in immunocompromised patients is often recurrent, protracted and multidermatomal, and it can result in myelitis, meningoencephalitis, and cerebral or small-vessel vasculopathic or vasculitic changes. Commonly, the vesicular rash settles with aciclovir therapy and does not involve motor neuropathy. We report a 63-year-old man with a prolonged, multidermatomal, nonvesicular rash, and limb paresis secondary to brachioplexitis. PCR for VZV was positive, and the histological results were consistent with granulomatous vasculopathy. Prolonged treatment with valaciclovir was required to resolve the eruption and help improve the patient's motor function. We discuss the problems faced in clinical decision-making about immunosuppressive treatment of granulomatous vasculopathy and motor neuropathy, when any increase in immunosuppressive therapy may increase the likelihood of central nervous system complications.
Authors:
J Fleming; A Fogo; S Haider; S Diaz-Cano; R Hay; S Bashir
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental dermatology     Volume:  38     ISSN:  1365-2230     ISO Abbreviation:  Clin. Exp. Dermatol.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-04-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7606847     Medline TA:  Clin Exp Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  378-82     Citation Subset:  IM    
Copyright Information:
© The Author(s) CED © 2013 British Association of Dermatologists.
Affiliation:
Department of Dermatology, King's College Hospital, London, UK.
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