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• W4313454918 abstract "Dear Editor, Herpes zoster ophthalmicus (HZO) is an uncommon viral infection in childhood with an incidence of 42:1,00,000 persons per year.[1] Studies have shown that the incidence of Herpes Zoster is on the rise in older individuals, but there is a paucity of literature regarding this infection in children.[23] Most of the reported cases are related to immunosuppression and varicella infection acquired during the intrauterine or first year of life.[1] Here we report a case of a 5-year-old immunocompetent male child without any history of previous varicella infection or vaccination. The child presented to us with devastating complications of HZO. On examination, there was alopecia and cutaneous scarring in the ophthalmic and maxillary division of the trigeminal nerve dermatome on the right side. Furthermore, the patient developed severe ocular and adnexal involvement with grade 4 contracted socket and phthisis of the right eye [Fig. 1].Figure 1: (a) Localized alopecia and cutaneous scarring in dermatome innervated by ophthalmic division of the trigeminal nerve (arrow). (b) Presence of Hutchinson’s sign (black arrowhead), cutaneous scarring involving maxillary nerve dermatome (arrow), and severely contracted socket with the phthisical eye (blue arrowhead)HZO usually has a benign course in healthy children, seldom reported in the literature. However, the rising cases of HZO in children pose a significant challenge for patients and treating physicians. The reasons for this are still to be elucidated. Nevertheless, the disease is gruesome and unforgiving and may take an ugly turn during its course. Therefore, it is essential to keep a high index of suspicion to diagnose the disease in its early stage. Polymerase chain reaction (PCR) is a sensitive technique to identify viral DNA that could help clinicians distinguish it from other causes of rashes, including herpes simplex skin infection, contact dermatitis, and staphylococcal impetigo.[4] Furthermore, the presence of the Hutchinson sign should be taken with caution and warrants close monitoring. With this letter, we would also like to highlight that although vaccination against Varicella Zoster may protect against chickenpox, further studies are required to establish its effectiveness in preventing HZO in the pediatric age group.[5] We recommend that dermatomal rashes should never be taken timidly. Timely recognition, diagnosis, and intervention in cases of Herpes Zoster may avert its rare catastrophic complications. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest." @default.
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• W4313454918 date "2023-01-01" @default.
• W4313454918 modified "2023-10-01" @default.
• W4313454918 title "Herpes zoster ophthalmicus in an immunocompetent child: An unforgiving disease with devastating complications" @default.
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• W4313454918 doi "https://doi.org/10.4103/ijo.ijo_1340_22" @default.
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