Zosteriform Herpes Simplex Research Articles

Zosteriform Herpes Simplex Infection of V3 Dermatome

Human herpesviruses are prevalent DNA viruses that can cause various orofacial diseases. Diagnosis of herpes simplex virus-induced oral diseases is usually based on the clinical presentation and on the medical history. We hereby present a case of zosteriform herpes simplex infection in an immunocompetent male.

Herpes Zoster.

Primary care providers and hospitalists frequently encounter older or immunocompromised patients with herpes zoster accompanied by debilitating pain. Atypical presentations and zosteriform herpes simplex may present diagnostic challenges to clinicians. This article summarizes the background, evidence, and guidelines for the diagnosis, complications, treatment, and prevention of herpes zoster. Diagnosis of challenging cases relies on polymerase chain reaction as the preferred test. Treatment focuses on optimal use of antiviral therapy and analgesics. Prevention emphasizes utilization of a new recombinant zoster vaccine, which reduces the incidence of herpes zoster by more than 90% and is preferred to the live attenuated herpes zoster vaccine.

Annals for Educators - 7 August 2018.

Annals for Educators - 7 August 2018.

English

INTRODUCTION: Vesicular lesions present in a zosteriform appearance are usually due to herpes zoster [varicella zoster virus], but uncommonly can denote zosteriform herpes simplex [herpes simplex virus]. Such lesions if recurrent that too in an immunocompetent host is unusual & worth reporting. CASE REPORT: We present a case that came to OPD with chief complaints of recurrent painless fluid filled eruptions over lower back. The frequency of recurrence was about once in 6-7 months & the lesions appeared sometimes on lower back & sometimes on lower abdomen. On performing tzank smear, syncytial cells were seen. Serologically, IgG antibodies for herpes simplex virus were found. CONCLUSION: Thus, it was a case of recurrent zosteriform herpes simplex presenting in contralateral dermatomes. We are reporting this case because of its unusual presentation & rarity.

Revisiting Childhood Herpes Zoster

Herpes zoster is rare in otherwise healthy children, but it is more common in association with immunosuppression. Maternal varicella infection during pregnancy and varicella occurring in the newborn represent risk factors for childhood herpes zoster. However, some controversies persist about risk factors, diagnosis, and the natural history of childhood disease. In a 2-year prospective study, 18 children with herpes zoster were clinically diagnosed in outpatient consultations in a hospital dermatology unit. Data about age, dermatome involvement, underlying disease, and history of previous varicella were recorded. Tzanck smears, biopsy specimens, and sera were obtained from 18, 4, and 10 children, respectively. The varicella zoster virus major envelope glycoprotein gE was detected in 16 of 18 smears and all four biopsies. Herpes simplex virus I was demonstrated in one of the smears. The established risk factors for childhood herpes zoster were only found in one child. Evidence for previous full-blown varicella and varicella with few lesions was recorded in 7 and 4 of the 17 immunocompetent children, respectively. No history of varicella was recalled in 6 of 17 cases, although a serologic clue of past varicella infection (IgM negative, IgG positive) was disclosed. Recurrent herpes zoster was diagnosed in one immunocompromised child. Zoster-associated pain was localized and the disease severity remained mild in all children. Established risk factors for childhood herpes zoster were only rarely found in our series of patients. In contrast, unrecognized varicella and varicella with few lesions were frequently recorded and may represent additional risk factors for shingles in childhood. Zosteriform herpes simplex virus infections should be differentiated from childhood herpes zoster, emphasizing the importance of precise viral identification.

Recurrent periorbital zosteriform herpes simplex virus infection in childhood

ABSTRACT Introduction Zosteriform herpes simplex virus (HSV) infection is an uncommon presentation of HSV recurrent cutaneous infection and it is usually misdiagnosed as zoster. Methods We report a series of consecutive cases of zosteriform HSV that we recently managed. Results Four cases of recurrent zosteriform HSV infection in the second division of the trigeminal nerve were seen. Immunologic evaluation determined that the patients were immunocompetent. Culture and/or direct fluorescent stain diagnosed HSV. No ocular involvement was present, and all patients responded to oral acyclovir. Recommendations Clinicians should suspect HSV infection in patients with recurrent vesicular lesions with zosteriform appearance. Immunologic evaluation is not necessary; however, ophthalmologic examination to exclude ocular involvement is required. Oral acyclovir is useful for treatment.

“Recurrent herpes zoster”: An unproved entity?

Physicians sometimes misdiagnose recurrent zosteriform herpes simplex virus (HSV) skin infections as "zoster" or "recurrent zoster." Misdiagnosis can lead to inappropriate therapy with potentially harmful consequences, particularly in patients with ophthalmitis or immunosuppression, in which early institution of the correct antiviral therapy may be crucial. We report three patients who were originally misdiagnosed to have recurrent herpes zoster skin infections before we cultured HSV from their vesicles. We suggest: (1) that most recurrent zosteriform eruptions are caused by HSV; (2) that "recurrent zoster" has yet to be documented; and (3) that the diagnosis of "recurrent zoster" be reserved for those patients who have laboratory confirmation of recurrent varicella zoster (VZ). Viral culture or examination of vesicle contents by indirect immunofluorescent technic can provide definitive diagnosis of the etiology of a zosteriform eruption.