Disseminated herpes zoster in immunocompetent patients: Two cases report

Siti Aminah Tri Susila Estri; Nafiah Chusniyati

doi:10.15562/bmj.v10i3.2832

Disseminated herpes zoster in immunocompetent patients: Two cases report

Siti Aminah Tri Susila Estri ,

Nafiah Chusniyati ,

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DOI: https://doi.org/10.15562/bmj.v10i3.2832 |
Published: 2021-12-30

Abstract

Introduction: Disseminated herpes zoster (DHZ) characterized by the vesicles that appear outside the dermatome with more than 20 lesions. The DHZ common in immunocompromised patient. This case reports DHZ in the immunocompetent patients which is a rare case.

Case: The 45- and 60-years old men came with pain. The dermatological examination showed vesicles on the dermatomal and more 20 vesicles that outside of that dermatome. The patients diagnosed as DHZ involving the ocular and thoracic nerves. The patients work as carpenters who require strenuous physical activity with sun exposure. This physical fatigue can be a trigger for disseminated of lesions in herpes zoster. There are no other factors that can lower the body's resistance, such as systemic disease or drugs. The cases were treated with acyclovir systemic and anti-inflammatory with good results.

Conclusion: These cases showed that physical fatigue is one of the triggers for disseminated herpes zoster.

References

Rueda JM, Feito-Rodríguez M, Nieto D, Lucas-Laguna R de. Disseminated Herpes Zoster After Varicella Vaccination in a Healthy Boy. Actas Dermosifiliogr. 2017;108(6):587–8.
Lewis DJ, Schlichte MJ, Dao H. Atypical disseminated herpes zoster: management guidelines in immunocompromised patients. Cutis. 2017;100(5).
Chiriac A, Chiriac AE, Podoleanu C, Stolnicu S. Disseminated cutaneous herpes zoster-A frequently misdiagnosed entity. Int Wound J. 2020;17(4):1089–91.
Bollea-Garlatti ML, Bollea-Garlatti LA, Vacas AS, Torre AC, Kowalczuk AM, Galimberti RL, et al. Clinical Characteristics and Outcomes in a Population With Disseminated Herpes Zoster: A Retrospective Cohort Study. Actas Dermosifiliogr. 2017;108(2):145–52.
Vittarina P, Tumbelaka AR. Herpes Zoster Oftalmikus Sinistra Diseminata dengan Infeksi Sekunder pada Anak. Sari Pediatr. 2016;6(4):125.
Dubey V, MacFadden D. Disseminated varicella zoster virus infection after vaccination with a live attenuated vaccine. CMAJ. 2019;191(37):1025–7.
Jethwa T, Bertasi RAO, Kieneker L, Pattanaik S, Pujalte G. Bullous Disseminated Herpes Zoster: An Atypical Presentation. Cureus. 2020;12(7).
Widaty S, Soebono H, Nilasari H, Listiawan MY, Siswati AS, Triwahyudi D, et al. Panduan Praktek Klinis bagi Dokter Spesialis Kulit dan Kelamin Indonesia. Jakarta: PERDOSKI; 2017.
James W, Elston D, Berger T. Andrews’ Diseases of the skin: clinical dermatology. Philadelphia: Elsevier; 2016. 965 p.
Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018;41(2):95–105.
Petrun B, Williams V, Brice S. Disseminated varicella-zoster virus in an immunocompetent adult. Dermatol Online J. 2015;21(3).
Drone E, Ganti L. A Case of Disseminated Zoster in an Immunocompetent Patient. Cureus. 2019;11(12).
Weinberg A, Canniff J, Rouphael N, Mehta A, Mulligan M, Whitaker JA, et al. Varicella-Zoster Virus-Specific Cellular Immune Responses to the Live Attenuated Zoster Vaccine in Young and Older Adults. J Immunol. 2017;199(2):604–12.
Nakata A, Takahashi M, Irie M. Association of overtime work with cellular immune markers among healthy daytime white-collar employees. Scand J Work Env Heal. 2012;38(1):56–64.
Kim CK, Choi YM, Bae E, Jue MS, So HS, Hwang E-S. Reduced NK cell IFN-? secretion and psychological stress are independently associated with herpes zoster. PLoS One. 2018;13(2).
Sato Y, Miyake H, Thériault G. Overtime work and stress response in a group of Japanese workers. Occup Med (Chic Ill). 2009;59(1):14–9.
Nishitani N, Sakakibara H. Association of Psychological Stress Response of Fatigue with White Blood Cell Count in Male Daytime Workers. Ind Heal. 2014;52(6):531–4.
Rissardo JP, Caprara ALF. Herpes Zoster Oticus, Ophthalmicus, and Cutaneous Disseminated: Case Report and Literature Review. Neuroophthalmology. 2018;43(6):407–10.

[1] Rueda JM, Feito-Rodríguez M, Nieto D, Lucas-Laguna R de. Disseminated Herpes Zoster After Varicella Vaccination in a Healthy Boy. Actas Dermosifiliogr. 2017;108(6):587–8.

[2] Lewis DJ, Schlichte MJ, Dao H. Atypical disseminated herpes zoster: management guidelines in immunocompromised patients. Cutis. 2017;100(5).

[3] Chiriac A, Chiriac AE, Podoleanu C, Stolnicu S. Disseminated cutaneous herpes zoster-A frequently misdiagnosed entity. Int Wound J. 2020;17(4):1089–91.

[4] Bollea-Garlatti ML, Bollea-Garlatti LA, Vacas AS, Torre AC, Kowalczuk AM, Galimberti RL, et al. Clinical Characteristics and Outcomes in a Population With Disseminated Herpes Zoster: A Retrospective Cohort Study. Actas Dermosifiliogr. 2017;108(2):145–52.

[5] Vittarina P, Tumbelaka AR. Herpes Zoster Oftalmikus Sinistra Diseminata dengan Infeksi Sekunder pada Anak. Sari Pediatr. 2016;6(4):125.

[6] Dubey V, MacFadden D. Disseminated varicella zoster virus infection after vaccination with a live attenuated vaccine. CMAJ. 2019;191(37):1025–7.

[7] Jethwa T, Bertasi RAO, Kieneker L, Pattanaik S, Pujalte G. Bullous Disseminated Herpes Zoster: An Atypical Presentation. Cureus. 2020;12(7).

[8] Widaty S, Soebono H, Nilasari H, Listiawan MY, Siswati AS, Triwahyudi D, et al. Panduan Praktek Klinis bagi Dokter Spesialis Kulit dan Kelamin Indonesia. Jakarta: PERDOSKI; 2017.

[9] James W, Elston D, Berger T. Andrews’ Diseases of the skin: clinical dermatology. Philadelphia: Elsevier; 2016. 965 p.

[10] Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018;41(2):95–105.

[11] Petrun B, Williams V, Brice S. Disseminated varicella-zoster virus in an immunocompetent adult. Dermatol Online J. 2015;21(3).

[12] Drone E, Ganti L. A Case of Disseminated Zoster in an Immunocompetent Patient. Cureus. 2019;11(12).

[13] Weinberg A, Canniff J, Rouphael N, Mehta A, Mulligan M, Whitaker JA, et al. Varicella-Zoster Virus-Specific Cellular Immune Responses to the Live Attenuated Zoster Vaccine in Young and Older Adults. J Immunol. 2017;199(2):604–12.

[14] Nakata A, Takahashi M, Irie M. Association of overtime work with cellular immune markers among healthy daytime white-collar employees. Scand J Work Env Heal. 2012;38(1):56–64.

[15] Kim CK, Choi YM, Bae E, Jue MS, So HS, Hwang E-S. Reduced NK cell IFN-? secretion and psychological stress are independently associated with herpes zoster. PLoS One. 2018;13(2).

[16] Sato Y, Miyake H, Thériault G. Overtime work and stress response in a group of Japanese workers. Occup Med (Chic Ill). 2009;59(1):14–9.

[17] Nishitani N, Sakakibara H. Association of Psychological Stress Response of Fatigue with White Blood Cell Count in Male Daytime Workers. Ind Heal. 2014;52(6):531–4.

[18] Rissardo JP, Caprara ALF. Herpes Zoster Oticus, Ophthalmicus, and Cutaneous Disseminated: Case Report and Literature Review. Neuroophthalmology. 2018;43(6):407–10.

Disseminated herpes zoster in immunocompetent patients: Two cases report

Abstract

References

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