Subcorneal Pustular Dermatosis at the Site of Healed Herpes Zoster Infection: Wolf’s Isotopic Response

A 57 year-old male patient presented with slightly itchy and grouped vesiculopustular eruption on an erythematous base on the right side of the neck. The lesions started 4 weeks before admission, and the patient was treated with systemic acyclovir for herpes zoster at the same location 3 months ago. Tzanck and KOH smears, bacterial and fungal cultures were all negative. Histopathological findings were consistent with subcorneal pustular dermatosis and the patient was successfully treated with topical corticosteroids. Based on clinical and histological findings, the patient was diagnosed as Wolf’s isotopic response. To our knowledge, this is the first report of subcorneal pustular dermatosis that occurs at the site of healed herpes zoster infection.