Clinical, Cosmetic and Investigational Dermatology (Jul 2023)
A Case of Gangrenous Herpes Zoster Complicated with Candida albicans Infection
Abstract
Dongxue Wang,1,* Zhe Xu,2,* Linxi Zeng,1 Jinfang Zhang,1 Guoqiang Zhang1 1Department of Dermatology, The First Hospital of Hebei Medical University, Candidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, People’s Republic of China; 2Department of Dermatology, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guoqiang Zhang, Department of Dermatology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050031, People’s Republic of China, Tel +86 18633888122, Email [email protected]: Herpes zoster is a disease caused by varicella-zoster virus infection, which is characterized by dense clusters of vesicles distributed along unilateral bands of nerves and accompanied by neuralgia. Although the disease is self-limited, some patients may develop neurological, ocular, skin, or visceral complications.Case Presentation: We report a 65-year-old Chinese man with ulceration secondary to cutaneous blister rupture on the left lumbar abdomen, who was diagnosed with herpes zoster and did not respond to conventional treatment. Dermatological examination showed diffuse dark erythema with clear boundaries on his left waist and abdomen. Deep ulcers of different sizes were densely distributed with steep edges and relatively dry base, while yellow secretions and black scabs could be seen. Fungal microscopy showed a few pseudohyphae and clusters of spores. Meanwhile, the fungal culture of the secretions showed Candida albicans growth. Skin biopsy of the affected skin from the ulcer of the left abdomen revealed epidermal absence and clusters of spores in the superficial dermis. PAS staining was positive. The patient was diagnosed with gangrenous herpes zoster complicated with Candida albicans infection. After antifungal treatment based on the results of drug sensitivity, the patient’s condition was improved.Conclusion: This case reveals the co-existence of herpes zoster and Candida albicans infection, expands our understanding of overlapping diseases, and provides value for clinical diagnosis and treatment.Keywords: gangrenous herpes zoster, skin wound, fungal infection, Candida albicans
