Perianal Herpes Zoster Presenting as Suspected Child Abuse

Cutaneous mimickers of child abuse: a primer for pediatricians

“…Genital herpes zoster Herpes zoster (HZ) results from reactivation of latent varicella zoster virus (VZV) from sensory nerve ganglia which can occur at any time after the primary varicella infection [11]. It often begins as a prodrome of severe pain followed by painful eruption of grouped vesicles on an erythematous base within a sensory dermatome.…”

A not so simplex case of genital herpes

“…One of these patients received extensive, invasive investigations as the differential HZ had not been considered and also went on to experience disabling postherpetic neuralgia which may have been reduced or avoided through earlier diagnosis and appropriate management. A number of cases of ano-genital VZV infection have been identified in children, in which the laboratory confirmation of diagnosis was required in relation to concerns of child sexual abuse7 8…”

Interpretation of anogenital findings in the living child: Implications for the paediatric forensic autopsy

“…98 Herpes zoster in the genital area may cause undue alarm when lesions appear in the genital area before the appearance of the more generalised rash. 99,100 The rash of nickel allergy from a bed-wetting alarm has also been mistaken for herpes simplex and resulted in referral to protective services. 101 Aphthous ulceration can occur in the genital area in association with acute illness.…”