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An atypical presentation of multidermatomal herpes zoster: a case report

Authors
  • Alhayyas, Mohammed1
  • Chaudhry, Mehmood1
  • Berdouk, Sabrina1
  • 1 Sheikh Khalifah Medical City, Abu Dhabi, United Arab Emirates , Abu Dhabi (United Arab Emirates)
Type
Published Article
Journal
International Journal of Emergency Medicine
Publisher
Springer Berlin Heidelberg
Publication Date
Nov 30, 2020
Volume
13
Issue
1
Identifiers
DOI: 10.1186/s12245-020-00325-6
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundHerpes zoster (HZ) also known as shingles is a common dermatological pathology seen in the emergency department. Multidermatomal involvement is an uncommon presentation and usually is linked to immunocompromised individuals. However, it is rarely reported in the immunocompetent population.Case presentationWe report a 30-year-old Emirati male complaining of low-grade fever for 3 days, sore throat and an uncomfortable pruritic erythematous rash over his chest and back for 2 days. He was treated the day preceding his presentation in another facility for a presumed allergic reaction after taking ibuprofen. On physical examination, he was found to have exudative tonsillitis and influenza and was treated for both and discharged. He returned to the emergency department reporting increasing pain and was referred to be seen in the dermatology clinic where a biopsy was obtained, and he was discharged with a steroid topical cream. Fourteen days later, he returned to the clinic reporting crusting of the rash; the biopsy results were positive for herpes zoster. The diagnosis of multidermatomal herpes zoster was made, and he was then treated with antivirals.ConclusionsHerpes zoster can present with atypical manifestations. Multidermatomal HZ is a rare dermatological manifestation in the immunocompetent adult. It is characterised by a rash spread over two or more adjacent dermatomes. This case highlights the challenging diagnosis of this dermatological presentation.

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