Varicella-zoster virus is a herpesvirus that causes infection in humans. The reactivation of latent VZV manifests as herpes zoster or shingles. In immunocompetent children, reactivation is rare, as increasing age is the most common risk factor for reactivation. Common complications of herpes zoster include post-herpetic neuralgia, secondary bacterial infection, and neurological sequelae.
Here is the case of a otherwise healthy and fully vaccinated 13 year old girl who presented with multiple fluid filled lesions on left side of forehead , left upper eye lid since 2 days . patient gave history of mild- moderate intensity burning type of pain prior to onset of rash.No complaints of similar lesions in family, no known co-morbidities.On examination there were multiple well defined grouped vesicles on an erythematous base on left side of forehead and upper eye lid . there were multiple erosions with crusting seen on the same area . a diagnosis of varicella was made and patient was started on tablet acyclovir and topical mupirocin. Patient was reviewed in OPD where the lesions had resolved with post inflammatory hyperpigmentation. There were no complaints of post herpetic neuralgia.
Herpes zoster results from the reactivation of a latent VZV infection and is rarely seen in healthy children. Varicella in early childhood is a risk factor of Herpes zoster (HZ) in immunocompromised and immunocompetent children.The appearance of HZ in a young child does not always imply an underlying immunodeficiency or malignancy. The identification of HZ with or without immunodeficiency is of prime importance from the treatment and prognostic point of view and should be considered in the differential diagnosis of vesicular eruptions.