Bullous Varicella in an Immunocompetent Adult: A Case Report

Chickenpox is a common viral infection that usually runs a benign course. Bullous varicella is an atypical presentation of chickenpox, which is usually seen in immunocompromised individuals. We describe a 54-year-old immunocompetent woman who presented to the emergency room with a 10-day history of fever and painful, fluid-filled lesions on her face, trunk, and extremities. Upon examination, the face, trunk, and extremities showed many vesicles, pustules, and bullae over an erythematous base. Multinucleated giant cells (MNGs) with acantholytic cells were visible in the Tzanck smear. A diagnosis of bullous varicella was made based on the appearance of the lesions and the results of the Tzanck smear. The patient was treated with intravenous acyclovir and antibiotics. We report this case due to the rarity of bullous varicella in immunocompetent adults.