Acne-like presentation of recurrent varicella infection in a child with nephrotic syndrome

Abstract

Primary infection with varicella zoster virus was assumed to confer lifelong immunity. Nevertheless, cases of varicella reinfection had been reported regardless of immune status. Here the authors described a case of 11-year old girl with nephrotic syndrome, currently on 80 milligrams of prednisolone for one month. She presented with one day of fever, diarrhea and acne-like rash at her forehead, nose and few on the neck. She had a past history of chickenpox. Her vesicles were examined by pediatric dermatologist and Tzanck smear was performed. Multinucleated giant cells were detected and diagnosis of varicella was made. This report infers that positive varicella history alone might not be sufficient to confer immunity, especially in immunocompromised host. Atypical presentation of recurrent varicella in immunocompromised host can be presented.