# Bullous Varicella in an Immunocompetent Adult: A Case Report

## TL;DR

A 54-year-old immunocompetent woman developed a rare form of chickenpox called bullous varicella, which is typically seen in people with weakened immune systems.

## Contribution

This case report highlights the rare occurrence of bullous varicella in an immunocompetent adult.

## Key findings

- The patient presented with fever and fluid-filled lesions consistent with bullous varicella.
- Tzanck smear confirmed the diagnosis by showing multinucleated giant cells and acantholytic cells.
- The patient was successfully treated with intravenous acyclovir and antibiotics.

## Abstract

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.