Multiple dermatomal daughter lesions of postzoster granuloma

Abstract

Conflicts of interest: none declared. Sir, Various cutaneous lesions are known to occur at sites of prior herpes zoster infection. Among such ‘isotopic responses’,1 granulomatous disorders are one of the most frequently reported cutaneous changes. We describe a patient with postzoster granuloma on the abdomen, who later developed additional multiple granulomatous lesions in a dermatomal pattern on the back. An 80‐year‐old woman presented with a persistent, slightly itchy dermatosis on her abdomen and back. Four years previously, she had developed painful eruptions on the right lower abdomen that had been diagnosed as herpes zoster by her physician. The initial lesions healed with no neuralgia. Two years later, slightly itchy reddish skin lesions began to appear at the same site and gradually increased in number. One month prior to her first presentation to our clinic, a similar dermatosis had started to develop at the bilateral sides of the upper back, where no preceding skin changes had ever been noted. The patient's history was negative for diabetes mellitus, malignancies or any immunological disorders.