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April 1990

Cutaneous Cytomegalovirus or Disseminated Verrucous Varicella Zoster-Reply

Author Affiliations

Dermatology Service Hôpital Henri Mondor Creteil, France

Department of Public Health, Parasitology and Tropical Medicine Hôpital de la Salpêtrière Paris, France

Virology Service Hôpital Trousseau Paris, France

Anatomy-Pathology Service Hôpital de la Pitié Paris, France

Arch Dermatol. 1990;126(4):538-539. doi:10.1001/archderm.1990.01670280123027

In Reply.—  We would like to thank Drs Berger, Mills, and Jacobson for their interesting comments.We think that their patients with chronic varicella zoster virus infection are different from the two patients we described with cytomeglovirus infection. Clinically, the lesions of their patients are in a zosteriform distribution. Their histopathologic findings, limited to the epidermis, are related to a varicella zoster virus resistant to acyclovir.Our first patient previously had anal herpetic lesions, with viral cultures positive for herpes simplex virus 2, which responded to a 5-day course of oral acyclovir, without relapse. He never received ganciclovir. He had only one verrucous lesion on the heel, with histopathologic changes characteristic of cytomegalovirus infection.The second patient had varicella 2 years previously, and 1 year later, intercostal herpes zoster culture-proved lesions, without cutaneous or visceral dissemination. The lesions healed spontaneously and he never received acyclovir or ganciclovir; he never had

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