Rare Case of En Bloc Palmar Desquamation in Extensive Chickenpox A Unique Dermatological Manifestation

Introduction: Chickenpox, caused by the Varicella Zoster Virus (VZV), is commonly known for its vesicular eruptions, but rare cases can present with extensive skin manifestations. A recent case highlights an uncommon feature—en bloc palmar desquamation—providing insights into the dermatological complications of severe chickenpox. Visit https://www.clinmedcasereportsjournal.com/acr for more groundbreaking research on rare medical cases.

Case Summary: A 25-year-old man presented with fever and a progressive rash, which by day 4 had developed into extensive vesicular eruptions covering his trunk, face, and limbs. Key clinical observations included:

• Temperature: 100.2°F
• Heart Rate: 94 beats/min
• Blood Pressure: 122/76 mmHg
• Laboratory Findings: White cell count of 9300/mm3, neutrophils at 73%, lymphocytes at 23%
• CRP Levels: Elevated at 65 mg/L (normal: 0-5 mg/L)

By day 13, the patient exhibited en bloc desquamation of palmar skin, an exceedingly rare complication associated with VZV infection.

Diagnosis and Treatment: A serological test confirmed Varicella Zoster Virus (VZV) infection via PCR testing. The patient underwent:

• Intravenous Acyclovir (1000 mg thrice daily for 10 days)
• Prophylactic antibiotics to prevent secondary bacterial infection (IV antibiotics for 7 days, followed by oral amoxicillin/clavulanate for 5 days)

Although skin desquamation is reported during the convalescent phase of viral infections, extensive palmar desquamation in chickenpox is rarely documented.

Broader Implications in Dermatology: According to the American Academy of Dermatology (AAD), viral exanthems can cause post-inflammatory skin peeling, but severe cases like this highlight the need for early intervention and monitoring in extensive VZV infections. The AAD emphasizes timely antiviral therapy to prevent complications and improve patient outcomes.

Read More: Explore the full study at https://doi.org/10.29328/journal.acr.1001100. Additionally, discover related cases and in-depth medical insights on our main journal article.

Key Takeaways:

• En bloc palmar desquamation is an uncommon complication of extensive chickenpox.
• Early antiviral treatment is crucial to mitigate severe dermatological outcomes.
• Proper follow-up and dermatological assessment are necessary to manage post-viral skin complications.

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