Post-herpetic abdominal pseudohernia – An uncommon/under-recognized complication of a common disease, herpes zoster – A case report

Abstract

Acute zoster pain and post-herpetic neuralgia are the most common and nagging complications after herpes zoster. Sometimes, temporary paresis of the segmental nerves follows herpes zoster resulting in zoster paresis or muscle zoster. Here, we report a case of zoster paresis manifesting as post-herpetic abdominal pseudohernia. A 55-year-old male presented to the dermatology outpatient department with the complaints of intense pain, burning sensation, and paresthesia over the left side of his abdomen. He had a history of herpes zoster over the same site 2 weeks back. Then, he noticed a swelling over the left side of his abdomen, associated with bloating, decreased appetite, and easy satiety. Examination revealed hyperpigmented scars of herpes zoster in the T9-T11 dermatome along with an ipsilateral bulge of size 20 × 15 cm over the same site. The skin overlying the bulge was lax. The swelling increased in size following coughing and Valsalva maneuver. An ultrasonogram of the abdomen ruled out a ventral hernia. One should be aware of this entity, when examining patients with abdominal bulge along with herpes zoster scars, to avoid unnecessary surgeries.