Abstract
Introduction: Herpes zoster (HZ) manifests as vesicular lesions typically involving thoracic dermatomes and rarely sacral dermatomes. Here, we present the case of a 32-year-old immunocompetent man with an atypical presentation of HZ misdiagnosed as herpes simplex virus (HSV). Case presentation: A 32-year-old man first presented with an erythematous rash with increasing pain severity on the right side of the glans penis involving the S2–S3 dermatomes. Repeated polymerase chain reaction (PCR) tests yielded negative results for both HZ and HSV. The appearance of vesicular lesions on the penis led to an initial misdiagnosis of HSV, causing a great emotional burden on the patient. Discussion: HZ occurs uncommonly in the sacral dermatomes. The clinical manifestations of HSV and HZ are similar and must be distinguished via careful diagnostic approaches using PCR testing. The unique symptoms of HZ are unilateral vesicular lesions and post-herpetic neuralgia. Conclusion: Penile HZ should be considered in patients presenting with unilateral, localized vesicular lesions.
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