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Picture of the Month

Karen E. Pond, MD; Henry M. Feder Jr, MD; Walter W. Tunnessen Jr, MD
Arch Pediatr Adolesc Med. 1995;149(3):313-314. doi:10.1001/archpedi.1995.02170150093017.
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VESICULAR ERUPTIONS that were consistent with varicella developed in three children and an adolescent at sites of preceding skin disruption (Figure 1 through Figure 4).

Denouement and Discussion 

Atypical Presentations of Varicella With Underlying Skin Disorders  Varicella affects approximately 3.5 million children annually in the United States. It is characterized by an acute illness consisting of fever, malaise, anorexia, and a papulovesicular rash that begins on the trunk and spreads to the extremities and face. Varicella is generally a benign and self-limited disorder, but with underlying skin damage, atypical or more severe infections may occur.Varicella and other viral exanthems may be exacerbated by skin trauma. Sun exposure, as well as other physical and chemical agents that damage the skin, may result in atypical presentations or accelerations of viral exanthems.1 Multiple reports of varicella erupting in sunburned skin, known as photolocalized varicella, have been published since 1968.1-8 Patients


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