A Clinical Study of Chicken Pox in Adolescents and Adults / 대한피부과학회지

ABSTRACT

BACKGROUND: Chicken Pox, a highly contagious exanthem that occurs most frequently in childhood, is the result of primary infection with varicella zoster virus. Although it is generally a benign, self-limiting disease, varicella zoster virus infection may be associated with serious complications, especially in older adults. OBJECTIVE: The aim of this study was to elucidate the epidemiological and clinical characteristics and histopathologic features of varicella in adolescents and adults. METHOD: 57 patients who were admitted with varicella as adolescents or adults during a 20-year period from 1985 to 2004 were evaluated in regard to age, sex, monthly incidence, prodromal symptoms, and cutaneous manifestations. Patients were further assessed over abnormalities of laboratory tests, associated diseases, or histopathologic features. RESULTS: The results were as follows 1. Varicella was seen most frequently in the 20~29 year-old group (47%), followed by the 10~19 year-old group (30%). The ratio of males to females was 1.36 1. As a result of calculating the average age in five-year peroids from 1985 to 2004, the average age in the last period (2000-2004) was 29.2 +/- 7.0 years. This was found to be higher than in the other 5-year periods. 2. With regard to monthly occurrence, varicella was found to be most prevalant in May (21%). 3. The most common prodromal symptom was fever (74%), followed by a sore throat (32%) and headache (30%). 4. Common cutaneous manifestations of varicella were papules (84%), vesicles (79%) and typical umbilicated vesicles (65%). Pruritus (96%) was an extremely common symptom. 5. The most common laboratory abnormality was an abnormal liver function (28%). 6. Associated diseases of varicella were observed in 6 patients (10%). These included hepatitis or the hepatitis B virus carrier (5%), diabetes mellitus (2%), pulmonary tuberculosis (2%), and ulcerative colitis (2%). 7. Complications of varicella were 1 case (2%) of keratitis and 1 case (2%) of secondary infection. 8. In 7 cases of varicella stained with hematoxylin-eosin, all cases showed necrosis of keratinocytes and ballooning degeneration, and 5 cases had severe inflammatory infiltrations. Intra-epithelial vesicles were found in 6 cases, and multinucleated giant cells were found in 2 cases. CONCLUSION: The mean age of varicella patients showed an increase in the last 5-year period. In adolescents and adults with varicella, we recommend that patients should be evaluated for abnormalities of liver function.