Multidermatomal herpes zoster: a pain in the neck?

Beuerlein, Katherine G; Strowd, Lindsay C.

doi:10.5070/d32511046150

Cited by 8 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Shorter sensory nerves in cervical and trigeminal areas could aid virus transit to the skin, unlike longer thoracic and lumbar nerves. Overall it involves a complex interplay between viral loads, their spread, nerve pathways, and the immune response 10 .…”

Section: Discussionmentioning

confidence: 99%

Multidermatomal herpes zoster triggered by psychological stress in an immunocompetent young adult: a rare case report and clinical insights

Yogi,

Bhusal,

Subedi

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Introduction and importance: Herpes zoster(HZ), a reactivated varicella zoster virus infection arising from dormant viral latency after initial chickenpox, manifests as localized skin rashes along dermatomes. Multi-dermatomal involvement, especially in immunocompetent individuals, is rare. The potential link between psychological stress and HZ reactivation remains underexplored. We present a case of multi-dermatomal HZ triggered by psychological stress in a young immunocompetent adult. Case Presentation: A 26-year-old male presented with vesicular lesions spanning C5, C8, T1, and T2 dermatomes, triggered by psychological stress. The disease exhibited a unique midline-crossing presentation. Varicella zoster virus IgM test result was positive. Treatment included acyclovir, pain management, and stress reduction strategies, yielding complete resolution within three weeks. Clinical Discussions: The case highlights a distinctive multi-dermatomal HZ presentation, defying conventional dermatomal restrictions. Psychological stress potentially influenced viral reactivation. Immunocompetence and stress interplay merit further exploration. Multi-dermatomal HZ necessitates prompt clinical recognition and comprehensive evaluation. Antiviral therapy and integrated stress management may contribute to successful outcomes. Conclusion: This case underscores the rare occurrence of multi-dermatomal HZ in an immunocompetent young adult triggered by psychological stress. The atypical presentation and potential role of stress in viral reactivation emphasize the complex interaction between the nervous and immune systems. Integrated clinical management, stress reduction strategies, and antiviral therapy were effective in resolving the condition. Further research is warranted to elucidate the mechanisms underlying stress-induced viral reactivation and its clinical implications.

show abstract

Section: Discussionmentioning

confidence: 99%

Multidermatomal herpes zoster triggered by psychological stress in an immunocompetent young adult: a rare case report and clinical insights

Yogi,

Bhusal,

Subedi

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“…Shingles occur after reactivation of latent Varicella zoster virus (VZV) in the dorsal root ganglion (1)(2)(3). Commonly, the primary infection is chickenpox, which is acquired in childhood.…”

Section: Introductionmentioning

confidence: 99%

“…Commonly, the primary infection is chickenpox, which is acquired in childhood. After primary infection, VZV can be latent in neural tissue and can be reactive spontaneously or because of various risk factors (2,3). The most common risk factors are age >50 years, immunosuppression, infection and mental stress (1,2).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Shingles on the big toe

Saricicek,

Saricicek

2024

Preprint

View full text Add to dashboard Cite

Shingles occur after reactivation of latent Varicella zoster virus (VZV) in the dorsal root ganglion. Usually, chickenpox infection is a primary infection that occurs in childhood. After primary infection, VZV can be latent in neural tissue and can be reactive spontaneously or because of various risk factors. The most common risk factors are age >50 years, immunosuppression, infection and mental stress. Symptoms appear in 3 phases: preeruptive, acute exudative and chronic. Symptoms usually start in the preeruptive phase. Typically, patients present with painful or pruritic band-like vesicular lesions that do not cross the midline of the body. The most common site of shingles is the thoracic area. In this case report, we describe the atypical presentation of shingles with rare dermatomal involvement in a 55-year-old female patient who had a history of a significant immunocompromised state.

show abstract

“…VZV in the C2 distribution, sometimes known as herpes zoster occipitocollaris, is rarely reported, usually as single cases, 4,5 although multidermatomal zoster including involvement of cervical dermatomes has also been presented on occasion. 6 Secondly, perhaps as a consequence of this rarity, C2 herpes zoster is not specifi cally recognised in the current International Classifi cation of Headache Disorders (ICHD-3), unlike painful trigeminal neuropathy and painful nervus intermedius neuropathy attributed to herpes zoster (sections 13.1.2.1 and 13.3.2.1, respectively). 7 The ICHD-3 Appendix has a section on 'headache attributed to upper cervical radiculopathy' (A11.2.4).…”

Section: Introductionmentioning

confidence: 99%