A 60-year-old man with non-Hodgkin lymphoma on chemotherapy develops widespread vesicular lesions. Some lesions follow the T5 dermatome, but there are also more than 25 vesicles scattered over the trunk and limbs distant from the affected dermatome. What is the most appropriate description of this condition?

• A Multidermatomal zoster
• B Disseminated zoster ✓
• C Eczema herpeticum
• D Herpes simplex reactivation

Explanation

Disseminated zoster is defined as the presence of more than 20 vesicles outside the primary and adjacent dermatomes, typically occurring in immunocompromised patients. Multidermatomal zoster involves two or more contiguous or non-contiguous dermatomes without widespread distant lesions. Eczema herpeticum is a HSV infection superimposed on pre-existing skin disease like eczema.

Reference: Rook's Textbook of Dermatology, 9th ed.

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