Chronic varicella presenting as disseminated pinpoint-sized papules in a man infected with the human immunodeficiency virus.

A 39-year-old HIV-infected man had manifested a typical varicella successfully treated with intravenous acyclovir. Despite oral acyclovir, he developed 10 days later a widespread eruption of pinpoint-sized erythematous papular lesions. Histologic examination and viral culture showed a persistent varicella-zoster virus (VZV) infection. Intravenous acyclovir and foscarnet were both efficient. However, each withdrawal of intravenously administered treatment resulted in a rapid relapse. Among the atypical forms of chronic varicella, this eruption appears to be unique. As in our case, chronic VZV infection appears often to be a difficult therapeutic challenge.