Herpes Zoster

Greg Rosencrance, M.D.

N Engl J Med 1994; 330:906March 31, 1994

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Figure 1 Herpes Zoster.

A 78-year-old man had numerous crusts and erosions on the right side of his face and scalp. Staining with a monoclonal-antibody stain (Syva Microtrak, Palo Alto, Calif.) conjugated with fluorescein isothiocyanate specific for varicella-zoster virus glycoproteins was performed on fluid from lesions on the patient's back and was positive. An ophthalmologic examination also revealed keratitis. The only risk factor identified for dissemination was the daily use of 1 percent hydrocortisone cream when the facial lesions first appeared. The patient was treated with intravenous acyclovir along with trifluridine and sulfacetamide-prednisolone eye drops. After the lesions disappeared, postherpetic neuralgia developed.

Kim Eagle, M.D.

Greg Rosencrance, M.D.
West Virginia University Health Sciences Center, Charleston, WV 25304

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