case_images: PMC10774547_01
case_images: Clinical manifestations in the first visit. (A) Papules, papular vesicles, crusted vesicles, and crusts are mutually intermingled on the back. (B) Vesicles <6 mm in diameter are shown. Some vesicles have an umbilication representing necrosis in the center.
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case_images: PMC10774547_01_CCR3-12-e8422-g001.jpg
case_images: ccr38422-fig-0001
case_images: In the first visit, the eruptions became vesicles, which spread over the body (Figure 1).
case_images: CT imaging of lungs. Ground-glass opacities are observed in the bilateral lungs; however, no nodules suggestive of varicella pneumonia are found.
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case_images: PMC10774547_01_CCR3-12-e8422-g002.jpg
case_images: ccr38422-fig-0002
case_images: Bilateral ground-glass opacities were observed on chest computed tomography (CT) (Figure 2).
case_images: Histopathological findings of vesicles. (A) Hematoxylin-eosin stain, x400. Intraepidermal blisters with large multinucleated giant cells and intranuclear inclusion bodies shown as a pale amorphous substance are evident. (B) Direct immunofluorescence, x1000. The nuclei of cells in vesicles are reactive to an anti-VZV antibody (Denka, Tokyo, Japan), as indicated by white arrowheads.
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case_images: PMC10774547_01_CCR3-12-e8422-g004.jpg
case_images: ccr38422-fig-0003
case_images: A histopathological examination revealed intraepidermal blisters with large multinucleated giant cells and intranuclear inclusion bodies (Figure 3A). An immunohistochemical examination of vesicle tissue showed VZV antigens in keratinocytes on the adjacent side of blisters (Figure 3B), but failed to detect CMV antigens.