Vasculitis-like herpes zoster in the course of treatment with tofacitinib in ulcerative colitis: An assessment of local viral distribution by RNA in situ hybridization.

He was referred to our department for a refractory ulcer on his lower leg.

We suspected vasculitis and performed skin biopsy.

Histopathological examination showed multinucleated giant cells in the epidermis and fibrinoid degeneration of small vessels in the upper dermis.

We further performed RNA in situ hybridization using a varicella zoster virus ORF9 mRNA probe and clearly showed that the distribution of varicella zoster virus mRNA extended into the dermis, including the dermal vessel walls and the eccrine sweat glands as well as the epidermis.