Bullous Erythema Multiforme following Herpes Zoster

ABSTRACT

Erythema multiforme is a self-limited, usually mild and relapsing exanthematic intolerance reaction of the skin that is etiologically most often related to recurrent herpes simplex virus infection. Until now, despite its increasing incidence, varicella zoster virus has rarely been considered as an etiologic agent. We herein report a case of erythema multiforme following herpes zoster. A 52-year-old man complained of multiple targetoid lesions with central bullae which developed 1 day ago and were progressively spreading to his whole body. He had suffered from the thoracic herpes zoster along the right T11-, and T12-dermatomes for 10 days. He had no history of HSV infection. He had been intermittently taking analgesics such as acetaminophen for 1 year because of low back pain, but had no history of drug eruption due to analgesics. Histopathologic examination showed subepidermal bulla with necrotic keratinocytes and vacuolization of the basal layer. Based on the clinical morphology and the histopathologic findings, our case could be presumptively diagnosed as a bullous erythema multiforme following herpes zoster.