SOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDARNI K.KRISTJANSSONMD
Histopathologic examination of the lesional biopsy specimen revealed epidermal changes typical of herpes virus infections: intraepidermal vesicles, enlarged acantholytic keratinocytes with steel-gray nuclei, and some multinucleated keratinocytes. In addition, leukocytoclastic vasculitis with fibrin deposition, neutrophils, and nuclear dust was present in the upper dermis. The diagnosis of varicella zoster virus (VZV) infection was confirmed by immunofluorescence microscopy of material from the blister floor using a VZV-specific antibody. Intravenous acyclovir therapy for 10 days resulted in rapid resolution of all lesions.
Longstanding Painful Hemorrhagic Vesicles and Erosions on the Lower Leg—Diagnosis. Arch Dermatol. 2011;147(2):235-240. doi:10.1001/archdermatol.2010.426-b