Wolf's isotopic response: zosteriform morphea appearing at the site of healed herpes zoster in a HIV patient

López, N. Palomo; Alcaraz, I.; Cid-Mañas, J; Camacho, Elvira; Herrera‐Acosta, Enrique; Matilla, Alfredo; Herrera, Enrique

doi:10.1111/j.1468-3083.2008.02711.x

Cited by 26 publications

(20 citation statements)

References 9 publications

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“…3 These include leukemic infiltration, lymphoma, lichen planus, morphea, reactive perforating collagenosis, melanoma metastases, angiosarcoma, and infections. [4][5][6][7][8][9][10][11] Given this broad range of dermatologic disorders, including malignancy, that can present in a zosteriform distribution, a skin punch biopsy is recommended for confirming the diagnosis in clinically atypical cases.…”

Section: Casementioning

confidence: 99%

Wolf Isotopic Response Manifesting as Postherpetic Granuloma Annulare: A Case Series

Kapoor

Piris²,

Saavedra³

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Wolf isotopic response has infrequently been reported in the literature, mainly as isolated case reports. Objective.— To aid in recognition of the occurrence of postherpetic granuloma annulare for accurate histologic interpretation of granulomatous dermatitides. Design.— We report 5 cases of patients with Wolf isotopic response manifesting as granuloma annulare, developing in a site of previous herpes zoster, and discuss the clinicopathologic findings. Results.— Previous infection with herpes zoster or herpes simplex virus was found in 5 of 5 cases reported. The differential diagnosis of a dermal lymphohistiocytic infiltrate with multinucleated giant cells includes postherpetic granuloma annulare. Conclusions.— All cases of postherpetic Wolf isotopic response reported in this series revealed granuloma annulare, with a perineurovascular or perifollicular pattern of lymphohistiocytic infiltration including multinucleated giant cells, and occurred following herpes zoster or herpes simplex infection, although herpes viral infection was not always associated with a subsequent isotopic eruption. Awareness of this entity can aid in the clinicopathologic diagnosis of granuloma annulare occurring at the site of prior herpes viral infection.

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Section: Casementioning

confidence: 99%

Wolf Isotopic Response Manifesting as Postherpetic Granuloma Annulare: A Case Series

Kapoor

Piris²,

Saavedra³

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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“…[5][6][7] Herpes zoster infections may cause atypical delayed-type hypersensitivity reaction to viral antigen or a tissue antigen alteration hypothetically. 4 A few cases of ZM localized on the site of improved herpes zoster infection have been reported previously. 3,4 Zoster sine herpete, which has a chronic radicular pain without rash due to varicella zoster virus (VZV) reactivation, should be ruled out from ZM.…”

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confidence: 99%

“…4 A few cases of ZM localized on the site of improved herpes zoster infection have been reported previously. 3,4 Zoster sine herpete, which has a chronic radicular pain without rash due to varicella zoster virus (VZV) reactivation, should be ruled out from ZM. 7 Our patient did not have a radicular pain and rash on site of disease.…”

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confidence: 99%

“…Most of them have been described on the same area of preceding herpes zoster infection as Wolf's isotopic response. 3,4 In this article, we report a case with usual morphea diagnosed histopathologically at unusual location without history of herpes zoster infection.An 18-year-old healthy, male patient presented with complaints of hardness and discoloration of the skin at the right posteroinferior side of his trunk with a zosteriform distribution of T 10-12 dermatomes, over a period of two years. We detected no characteristic finding in his medical/family history and physical examination except indurated plaque that measured 9x6 cm in diameter with central hyperpigmentation among the xyphoid and umbilicus that extended to the lateral part of the trunk with atrophic lesions in a zosteriform distribution (Figure 1).…”

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confidence: 99%

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Zosteriform Morphea Without History of Herpes Zoster Infection

et al. 2016

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Morphea is a rare connective tissue disorder. Hardening and thickening of the skin due to an increased density of collagen are its characteristic features.1 It has been classified into plaque or circumscribed, linear, generalized, morphea profunda (deep), pansclerotic and combined forms with wide clinical presentation.2 Zosteriform morphea (ZM), which is described as a dermatomal distribution of lesions like herpes zoster clinically, is a rare entity. Most of them have been described on the same area of preceding herpes zoster infection as Wolf's isotopic response. 3,4 In this article, we report a case with usual morphea diagnosed histopathologically at unusual location without history of herpes zoster infection.An 18-year-old healthy, male patient presented with complaints of hardness and discoloration of the skin at the right posteroinferior side of his trunk with a zosteriform distribution of T 10-12 dermatomes, over a period of two years. We detected no characteristic finding in his medical/family history and physical examination except indurated plaque that measured 9x6 cm in diameter with central hyperpigmentation among the xyphoid and umbilicus that extended to the lateral part of the trunk with atrophic lesions in a zosteriform distribution (Figure 1). We detected no history of herpes zoster or other skin lesions on the site of ZM, abnormal skin moisture, suggestive signs of other extracutaneous, musculoskeletal or systemic sclerosis. Serology for varicella-zoster virus tested negative for immunoglobulin M, but positive for immunoglobulin G. Anti-nuclear antibody, anti-human immunodeficiency virus, first-tier immunoglobulin M and immunoglobulin G enzyme immunoassays for Borrelia were negative. A skin biopsy revealed an interstitial lymphoplasmacytic infiltrate which surrounded eccrine coils and distributed among separated deep dermal thickened, hypocellular and swollen collagen bundles, and papillary dermal collagen elastic fibers (Figure 2). Laboratory studies including blood cell count, serum chemistry, and autoantibodies (antinuclear antibodies and antiScl-70 also called anti-topoisomerase 1) were all normal or negative. Clinical and pathological features were consistent with the diagnosis of morphea. A written informed consent was obtained from the patient.Zosteriform term describes the dermatologic morphology attributing to the distribution of herpes zoster. Some diseases such as lichen planus, parakeratosis, common warts, fungal infections, nevus, and skin metastases have been described with this pattern.3 Also, several types of cutaneous lesions such as granulomatous dermatitis, vasculitis and folliculitis, granuloma annulare, pseudolymphoma, keloid, sarcoidal granuloma, systemic lymphoma, leukemia cutis, lichenoid dermatitis such as lichen planus and sclerosis, cutaneous Rosai-Dorfman disease have been reported on the site of healed herpes zoster

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HIVand the Skin

Bunker

Piguet

2016

Rook's Textbook of Dermatology, Ninth Edition

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Acquired immune deficiency syndrome (AIDS) has been recognized, and human immunodeficiency virus (HIV) identified as the causative agent, for over 30 years. HIV infection is a significant health problem globally. Earlier diagnosis and initiation of antiretroviral treatment (ART) prevents death, serious sequelae and onward transmission. Mucocutaneous involvement may allow diagnosis at seroconversion or later in the course of the disease and dermatologists should have a very low threshold for considering the diagnosis and offering HIV testing routinely in many common presenting clinical scenarios. Combined ART has revolutionized treatment, and long‐term survival is the norm. However, there are significant dermatological consequences of HIV treatment including drug reactions/complications and immune reconstitution‐associated disease. Primary skin malignancies are the most frequent non‐AIDS‐defining cancers and oral, anal and genital (e.g. penile) cancers are significantly increased in the HIV‐treated population.

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Wolf's isotopic response: zosteriform morphea appearing at the site of healed herpes zoster in a HIV patient

Cited by 26 publications

References 9 publications

Wolf Isotopic Response Manifesting as Postherpetic Granuloma Annulare: A Case Series

Wolf Isotopic Response Manifesting as Postherpetic Granuloma Annulare: A Case Series

Zosteriform Morphea Without History of Herpes Zoster Infection

HIVand the Skin

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