A nonhealing scalp ulceration in a patient with a history of herpes zoster infection

Abstract

A 63-year-old male smoker presented with a nonhealing, enlarging wound on his right parietal scalp and an associated 2-month history of pruritus and “needle-like” pains. Medical history was significant for a herpes zoster eruption in the same area 7 months prior, treated with acyclovir. Examination found right-sided facial asymmetry with alopecia of the eyebrow, a sharply demarcated scalp ulceration with exposed periosteum, an angulated erosion at the anterior border of the ulcer, and another angulated erosion over the right medial eyebrow (Figs 1 and 2).