Herpes Zoster Duplex Unilateralis: Two Cases and Brief Literature Review

Abstract

Cases involving dermatomal herpes zoster in two or more locations are rare, especially in immunocompetent patients. When two noncontiguous dermatomes are involved, if affected unilaterally, it is called herpes zoster duplex unilateralis; if bilaterally, bilateralis. Here, we report two cases of herpes zoster duplex unilateralis. A 66-year-old man presented with painful erythematous grouped vesicles on his left scalp, forehead, trunk, and back (left [Lt.] V1, Lt. T8). Histologic findings were consistent with herpetic infection. A 33-year-old woman presented with painful erythematous grouped vesicles and crust on her left forehead and neck (Lt. V1, Lt. C5). Both patients were treated with oral administration of famcyclovir 750 mg/day for seven days.

Background paper to the decision not to recommend a standard vaccination with the live attenuated herpes zoster vaccine for the elderly in Germany

“…Normally only one side of the body is affected by the zoster exanthem. [14]. In 70-80% of HZ cases, a promodal stage of 3-5 days precedes the disease, with varying symptoms [15].…”

Editorial Board

“…Herpes zoster duplex has not been shown to increase the risk of postherpetic neuralgia. 4 D. Patients with herpes zoster duplex require prolonged treatment ([7 days) e Incorrect. The antiviral dosing and pain control in the management of herpes zoster duplex remain the same as that of classic herpes zoster.…”

Variations in herpes zoster manifestation

“…HZ duplex is crossing the midline of the body. This subtype is seen more often in Asia than in Europe 7 . An association to immunologic aberrations is present in <50 per cent of patients 7 .…”

“…This subtype is seen more often in Asia than in Europe 7 . An association to immunologic aberrations is present in <50 per cent of patients 7 . Multi-segmental HZ and generalized HZ represent a continuum of more severe manifestations (Fig.…”