A rare case of herpes zoster in a child involving dermatomes V1 and V2

Abstract

Herpes zoster (HZ) is rarely found in healthy children but may be attributed to immunocompromised children. Latent varicella-zoster virus (VZV) might have source from intrauterine exposure, chicken pox vaccination, or exposure to wild VZV. A 2 ½-year-old healthy boy presented with a painful red vesicular rashes with blisters on the right upper cheek, periorbital area, temporal and nasal area extending over the dermatomes V1 and V2 of 3 days' duration. There was an involvement of the right eye causing conjunctivitis. He had persistent frontal and temporal headache on the day 10 of the disease. Computed tomography scan of the brain reveals no abnormality. The child responded well to symptomatic management and routine skin care. Medications such as cetrizine, sup acyclovir, and local acyclovir ointment and emollients were given. Acyclovir was used orally in a dose of 20 mg/kg body weight every 6 hourly for 7 days. The patient recovered well in 10 days of treatment. HZ is a rare presentation in healthy children and needs a high index of suspicion to diagnose in cases with vesicular eruptions. In our case, the intrauterine infection is the source of latent VZV. HZ may not indicate that the child is immunocompromised.