A 35-Year-Old HIV-Infected Patient

Differential Diagnosis

• Allergic contact dermatitis
• Erysipelas
• Herpes simplex virus infection
• Herpes zoster in immunocompromised patient

Diagnosis
The image shows herpes zoster in this immunocompromised patient.

Learnings

• Herpes zoster (shingles) is a reactivation of a latent infection with the varicella-zoster virus
• After primary infection (chickenpox), the virus lays dormant for life. Reactivation may be triggered by immunosuppression, medications, infections, and physical or emotional stress
• Disseminated zoster (>20 vesicles) outside of the primary and adjacent dermatomes is chiefly a problem of patients with AIDS, those on immunosuppressive drugs, and patients with cancer