# Hemorrhagic and Ecthymatous Varicella in Immunosuppressed Adults: Report of Two Cases

## TL;DR

This paper reports two rare cases of severe varicella in adults with weakened immune systems, emphasizing the need for early diagnosis and treatment.

## Contribution

The paper presents two new case reports of hemorrhagic and ecthymatous varicella in immunosuppressed adults.

## Key findings

- Hemorrhagic and ecthymatous varicella can occur in adults receiving immunosuppressive drugs.
- Atypical skin lesions may lead to misdiagnosis in immunosuppressed individuals.
- Early diagnosis and treatment are crucial for preventing severe complications.

## Abstract

Varicella infection in immunosuppressed adults can be severe with atypical presentation of skin lesions. Hemorrhagic and ecthymatous varicella is a rare entity and can be misdiagnosed due to its atypical presentation. In its severe form, individuals with underlying cell-mediated immunodeficiency disorders have a high risk of developing multiple organ involvement associated with varicella-zoster virus infection. Here, we report two cases of primary varicella with hemorrhagic and ecthymatous skin lesions in adults receiving systemic immunosuppressive drugs for autoimmune disorders. There are only a few case reports on hemorrhagic and ecthymatous varicella. Hence, this case report highlights the atypical presentation of varicella in immunosuppressed adults, which necessitates an early diagnosis and prompt treatment as a lifesaving step.