Dermatomal lichenoid chronic graft‐vs‐host disease following varicella‐zoster infection despite absence of viral genome

Abstract

Localized cutaneous graft-versus-host disease (GVHD) following a dermatomal distribution or in a pattern of Blaschko's lines. Some authors have postulated that dermatomal GVHD is triggered by a varicella-zoster virus infection, although in reported cases, there was no history of a preceding herpes zoster. We describe a case of GVHD localized to the exact dermatome of a culture-proven varicella-zoster virus infection. PCR analysis failed to detect persistence of viral genome in the affected skin.

Superimposed segmental manifestation of polygenic skin disorders

“…[34][35][36][37][38][39][40]58 As a consequence, some investigators have even examined their patients for the presence of varicella-zoster virus. 49,68 The reports and photographs, however, clearly show that the arrangement was not zosteriform but followed Blaschko's lines. Hence, the term ''zosteriform,'' when applied to such cases, is a misnomer that should now be jettisoned.…”

“…The term ''dermatomal'' has likewise been used rather often 49,50 but is a misnomer. For example, Taïeb 74 has convincingly argued that segmental vitiligo is neither blaschkolinear nor dermatomal.…”

“…[47][48][49][50][51] Such superimposed segmental graftversus-host disease has so far often been mistaken as a ''dermatomal'' disorder after a varicella-zoster infection. 49,50 It should be emphasized that such arrangement is usually not dermatomal but follows Blaschko's lines. 47,51,52 On the other hand, exceptional cases of true zosteriform arrangement representing a Koebner's phenomenon induced by a herpes zoster infection may likewise occur.…”

Cutaneous Graft-versus-Host Disease: A Guide for the Dermatologist

“…Lichenoid lesions are characterized by erythematous or violaceous lichenoid papules and plaques that usually affect the dorsal aspects of the hands, forearms and trunk. They may show folliculotropism, rarely follow Blaschko’s lines or appear in the dermatomal site of a previous herpes zoster infection [72]. Sclerodermoid chronic GVHD often presents with plaques of dermal sclerosis that resembles morphea and eventually progresses to generalized scleroderma or, alternatively, presents with lichen-sclerosus-like features in a genital or extragenital distribution.…”

Pronounced Linear Calcinosis in a Boy with Mild Dermatomyositis

“…On the other hand, acquired inflammatory dermatoses with a Blaschko-linear pattern are rare, and their etiology was unknown until recently [2]. Such skin conditions include linear forms of lichen planus, lichen nitidus, atopic dermatitis, psoriasis, graft versus host disease, erythema multiforme, drug eruption, lupus erythematosus and pemphigus vulgaris, as well as inflammatory linear verrucous epidermal nevus, lichen striatus, blaschkitis of the adult and linear atrophoderma of Moulin [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. In some of these cases an excessively pronounced linear involvement has been described to be superimposed on a background of an eruption of the usual type.…”