Erythema multiforme associated with varicella.

Abstract

Erythema multiforme (EM) is a hypersensitivity dermatitis to different antigens including viral, bacterial and mycotic agents (1, 2, 3).
EM is part of a spectrum of disorders ranging in severity from papular EM to toxic epidermal necrolysis. Our case was characterized by large superficial blisters with centrifugal evolution centered by a varicella lesion. In the literature less than 10 cases of erythema multiforme associated with chickenpox have been described (3); in these cases erythema multiforme usually appears 2-10 days after the first clinical manifestations of varicella.
From a pathogenetic point of view it would be a delayed-type hypersensitivity reaction to viral antigens, which would involve the recruitment of virus-specific CD4+ cells with consequent release of interferon γ and epidermal damage (3).