ATYPICAL VARICELLA-ZOSTER INFECTION IN AIDS

A case of atypical varicella zoster in a 33-year-old AIDS patient is r eported. The patient had had two attacks of herpes zoster within a yea r and was given high-dose acyclovir several times. Thereafter he devel oped small keratotic pellucid papules on fingers, wrists and face, whi ch were found to contain varicella-zoster antigen by the ELISA test. S kin biopsy showed acanthosis and lack of vesication, as is usually see n in herpes infections. The atypical varicella-like lesions persisted despite repeated doses of acyclovir but cleared temporarily when the p atient was given foscarnet. We believe that the prolonged therapy may have allowed selection of acyclovir-resistant varicella-zoster strains , resulting in the atypical clinical course.