Rapidly Expanding Erosions in an Elderly Patient

Shaily P Bhatnagar and Amy W Fox

Department of Dermatology, University of North Carolina, USA

^*Correspondance to: Shaily P Bhatnagar 

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Abstract:

An 85-year old male with diabetes and dementia presented with a two-week history of rapidly growing erosions spanning multiple dermatomes on the left side of the face. Biopsy of the lesion was non-specific; however, a VZV PCR swab was positive, leading to the diagnosis of herpes zoster oticus. The patient was treated with valacyclovir and his rash ultimately healed. This case illustrates a unique presentation of herpes zoster. It typically arises as grouped vesicles in a single dermatomal distribution. Representing reactivation of the varicella zoster virus that lies dormant in the dorsal root ganglion, herpes zoster commonly affects the elderly and the immunosuppressed. Complications include Ramsay Hunt syndrome, which manifests as facial nerve paralysis secondary to herpes zoster oticus. Guanosine analogs are the mainstay of treatment for herpes zoster and recent studies demonstrate their efficacy even after the first 72 hours of symptoms. In the case of Ramsay Hunt Syndrome, corticosteroids should also be administered to avoid permanent paralysis. Ultimately, vaccination is the most effective way to prevent this illness and its long-term effects

Keywords:

Herpes zoster; Shingles; Infection; Ramsay-hunt

Cite the Article:

Bhatnagar SP, Fox AW. Rapidly Expanding Erosions in an Elderly Patient. Ann Clin Case Rep. 2016; 1: 1222.