Recurrent herpes zoster duplex symmetricus in HIV infection

Abstract

A HIV infected patirent with recurrent herpes zoster has been presented. Recurrence of herpes zoster contralaterally on the same dermatome and concomitant occurrence of three viral infections, viz. HIV, HPV and VZV in the same patient were the unusual and interesting observations in the present case report.

Chronic Herpes Zoster Duplex Bilateralis

“…One patient presented motor deficiencies without cutaneous involvement (22). One patient presented recurrent episodes of HZ duplex (13). In one child with HZ duplex, satellite VZV lesions continued to appear for a month (20).…”

Herpes zoster duplex bilateralis symmetricus

“…4e7 In these four cases, two cases occurred in immunocompromised patients, and all rashes were distributed on the thoracic dermatomes. In another report, 8 herpes zoster recurred 1.5 years later on the contralateral side of the same dermatome (the left T8 dermatome and then the right T8 dermatome) in a HIV-infected patient.…”

Herpes Zoster Duplex Symmetricus in an immunocompetent 70-year female

“…Although herpes zoster is typically unilateral, there has been only few reports of multiple dermatomal involvement [2,[7][8][9] and bilateral asymmetrical [2,9] distribution of herpes zoster lesions with incidence of approximately less than 1% [10]. This presentation has been referred to a zoster duplex unilateralis or bilateralis depending on whether one or both halves of the body is involved [1]. There have been few case reports of bilaterally symmetrical herpes zoster [7,8].…”

“…Herpes zoster may recur in the same or different dermatomes or in several contiguous or non contiguous dermatomes. Multiple recurrences of herpes zoster has been reported in HIV and immunocompromised patients [1]. Although herpes zoster is typically unilateral, there has been only few reports of multiple dermatomal involvement [2,[7][8][9] and bilateral asymmetrical [2,9] distribution of herpes zoster lesions with incidence of approximately less than 1% [10].…”

“…Herpes zoster is a neuroectodermal viral infection which afflicts one or more closely grouped, spinal or cranial nerves, resulting in unilateral radicular pain and vesicular eruption limited to a dermatome innervated by that nerve [1]. Bilateral involvement is rare, bilaterally symmetrical involvement is extremely rare.…”