Classically, recall
dermatitis refers to
chemotherapy-induced reactivation of skin damage caused by
radiotherapy months, or even years, earlier. The concept of recall
dermatitis has now been extended to include
radiation recall dermatitis induced by other drugs, ultraviolet radiation, extravasation of drugs, and
allergic contact dermatitis. We now describe recall
dermatitis along the residual cutaneous lesions of a previous thoracic
herpes zoster in a patient who developed a
drug eruption after
oral administration of
aciclovir. The most striking feature consisted of confluent linear
erythema along the dermatomes previously involved by the
herpes zoster episode. Histopathologic study demonstrated small foci of spongiosis, vacuolar changes involving the basal layer of the epidermis and single necrotic keratinocytes scattered within the epidermis. The papillary dermis appeared oedematous and with dilated blood capillaries surrounded by a sparse inflammatory infiltrate composed mainly of lymphocytes. Serial sections failed to demonstrate cytologic changes of herpes
varicella zoster infection. We interpreted this case as an example of recall
dermatitis because the widespread cutaneous eruption secondary to
aciclovir was more intense in skin previously compromised by herpes
varicella zoster infection. To the best of our knowledge, recall
dermatitis has not been described before at the site of previous involvement by
herpes zoster.