A rare case of varicella gangrenosum in adult
Keywords:Varicella gangrenosum, Chicken pox, Purpura fulminans
Varicella gangrenosum is a gangrenous ulceration of varicella lesions involving the skin and soft tissues of the body. It most commonly occurs in children less than 5 years of age and life threatening. This is a very rare complication of chicken pox in adults which deserves early diagnosis and management. 21-year-old male presented with blackish discoloration in the lateral aspect of right thigh for 5 days. He has positive history of chicken pox for his brother and sister following which he acquired it 15 days back. During that episode he had fever, headache and blisters which ruptured to heal by scab. But scab in right thigh coalesced to form the gangrenous area with serous discharge. On presentation he had no fever with local lesion and surrounding erythema. Patient underwent radical surgical debridement and regular dressing. Pus culture was sent which showed no growth. He gradually improved and the ulcer granulated well and split skin graft is done. Varicella gangrenosum is a life-threatening condition which can be either wet, moist or purpura fulminans. Patients who develop disseminated intravascular coagulation and have a grave prognosis. Surgical debridement is the only proven treatment which has led to better outcome. Only about 10 cases reported in literature so far regarding this condition.
Gerson A. Varicella vaccine. In: Plotkin S, Orenstein W, Offit P, editors. Vaccines. 6th ed. Saunders Elsevier; 2013: 836-869.
Stromberg BV, Brent S. Life-threatening varicella gangrenosum. Plast Reconstr Surg. 1989;83:924-5.
John TJ. Varieties of varicella gangrenosa. Pediatrics. 1977;60(3):384.
Sharma A, Agarwal S, Agarwal A, Sankhwar S. Posterior urethral valve associated with a foreign body in posterior urethra: a first of its kind report. BMJ Case Rep. 2019;12:e226363.
Judith PMS, Moons P, Jan HMS. Case reports in Medicine. Hindawi Publishing Corporation; 2014: 2066152.
Gnann Jr JW. Antiviral therapy of varicella-zoster virus infections. In: Arvin A, Campadelli-Fiume G, Mocarski E, et al., editors. Human herpes viruses: Biology, Therapy, and Immunoprophylaxis. Cambridge. Cambridge University Press; 2007: 65.