Abstract
Cowdry type A inclusion bodies (eosinophilic intranuclear inclusion bodies) have been found not only in epidermal cells, but also in dermal cells of mucocutaneous varicella zoster virus infections. We studied the pathogenesis of Cowdry type A inclusion bodies in dermal cells. Skin biopsies were obtained from 10 patients with herpes zoster, 10 patients with generalized eruptions of herpes zoster generalizatus and 6 with varicella. Capillary endothelial cells with Cowdry type A inclusion bodies were found in 1 out of 16 specimens from generalized eruptions and varicella, and in 4 out of 10 specimens from herpes zoster. Fibroblasts with Cowdry type A inclusion bodies were found in 4 out of 16 specimens from the former, and in 5 out of 10 specimens from the latter. Dermal cells with Cowdry type A inclusion bodies were located within the dermal papillae and the subpapillary layer just beneath the intraepidermal bulla. These observations indicate that Cowdry type A inclusion bodies in the dermal cells are due to direct spread of the virus from the intraepidermal bulla.
