Childhood Herpes Zoster-Triggered Guttate Psoriasis

Abstract

Psoriasis is commonly triggered or exacerbated by various stress factors, certain drugs, or streptococcal throat infections. Viral infections such as HIV, CMV, chikungunya, or herpes simplex virus are very uncommon triggers for psoriasis. Cases of varicella-triggered psoriasis are exceptional. A 7-year-old boy with a previous history of guttate psoriasis presented with generalized acute guttate psoriasis shortly after an extensive herpes zoster infection affecting the first and second left lumbar dermatomes. INF-alpha and granulocyte monocyte colony stimulating factor influence peripheral monocytes to transform into INF-dendritic cells (DC's), similar to those involved in psoriasis. These INF-DC's express toll-like receptors 7 and 8, which are responsive to viral single stranded RNA. Hence, viral infections and interferon (INF)-alpha may play a role in triggering psoriasis.