A case of disseminated herpes zoster with vesicles accentuated in an area treated with a wet compress

We describe a case of vesicular eruptions in an 82-year-old man ; the eruptions were present on the patient's head, trunk, and legs and were bunched together on his back. He had been suffering from rheumatoid arthritis and was treated with prednisolone and mizoribine. He had applied a wet compress on his back because he had been experiencing a backache for 3 days before the outbreak of the eruptions. A physical examination revealed numerous vesicles on his back, with bilaterally and unilaterally healed crust within the leision. Histological analysis of the vesicles on his back revealed an intraepidermal vesicle with balloon cells in the vesicle and multinucleate giant cells. Immunoglobulin (IgM) antibodies to varicella-zoster virus (VZV) were not detected using serological methods, whereas VZV IgG antibodies were detected by enzyme immunoassay (EIA). The patient was diagnosed with disseminated herpes zoster and the vesicles were accentuated in areas where the wet compress was placed. The patient was treated with acyclovir for 7 days. Varicella and disseminated herpes zoster are known to have predilection for sun exposure, pre-existing dermatosis, and skin injury. This is a rare case of disseminated herpes zoster showing vesicle accentuation in areas where a wet compress was placed.