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    Zosteriform Herpes Simplex and Herpes Zoster: A Clinical Clue

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    aulia maharani
    This document discusses the differences between zosteriform herpes simplex and herpes zoster infections. Specifically, it notes that the vesicles of herpes simplex are uniform in size within a cluster, while the vesicles of herpes zoster can vary in size. It adds this clinical clue to help differentiate between the two conditions when making a diagnosis. It also presents a case series of four patients diagnosed with piezogenic pedal papules, which are uncommon skin-colored papules on the feet that become prominent with physical activity and standing.

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    Zosteriform Herpes Simplex and Herpes Zoster: A Clinical Clue

    Uploaded by

    aulia maharani
    38 views3 pages
    This document discusses the differences between zosteriform herpes simplex and herpes zoster infections. Specifically, it notes that the vesicles of herpes simplex are uniform in size within a cluster, while the vesicles of herpes zoster can vary in size. It adds this clinical clue to help differentiate between the two conditions when making a diagnosis. It also presents a case series of four patients diagnosed with piezogenic pedal papules, which are uncommon skin-colored papules on the feet that become prominent with physical activity and standing.

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    Herpes

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    This document discusses the differences between zosteriform herpes simplex and herpes zoster infections. Specifically, it notes that the vesicles of herpes simplex are uniform in size within a cluster, while the vesicles of herpes zoster can vary in size. It adds this clinical clue to help differentiate between the two conditions when making a diagnosis. It also presents a case series of four patients diagnosed with piezogenic pedal papules, which are uncommon skin-colored papules on the feet that become prominent with physical activity and standing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    38 views3 pages

    Zosteriform Herpes Simplex and Herpes Zoster: A Clinical Clue

    Uploaded by

    aulia maharani
    This document discusses the differences between zosteriform herpes simplex and herpes zoster infections. Specifically, it notes that the vesicles of herpes simplex are uniform in size within a cluster, while the vesicles of herpes zoster can vary in size. It adds this clinical clue to help differentiate between the two conditions when making a diagnosis. It also presents a case series of four patients diagnosed with piezogenic pedal papules, which are uncommon skin-colored papules on the feet that become prominent with physical activity and standing.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Zosteriform herpes simplex and herpes zoster: A clinical clue

    Article  in  Indian Dermatology Online Journal · December 2013


    DOI: 10.4103/2229-5178.120643 · Source: PubMed

    CITATIONS READS
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    3 authors, including:

    Sheela Kuruvila Satyaki Ganguly


    Pondicherry Institute of Medical Sciences All India Institute of Medical Sciences, Raipur
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    Letters to the Editor

    Zosteriform herpes simplex 2.


    Dermatol Online J 2012;3:76‑7
    Kalman CM, Laskin OL. Herpes zoster and zosteriform herpes simplex
    virus infections in immunocompetent adults. Am J Med 1986;81:775‑8.
    and herpes zoster: A clinical 3. Habif TP. Clinical Dermatology. 5th ed. New Delhi: Elsevier; 2010.
    p. 454‑90

    clue 4. Lautenschlager S, Stockfleth E. Human herpes viruses. In: Burgdorf


    WHC, Plewig G, Wolff HH, Landthaler M, editors. Braun‑Falco’s
    Dermatology. 3rd ed. Heidelberg: Springer Medizin Verilag; 2009.
    Sir, p. 74‑92.
    This is in response to the article, ‘Recurrence of zosteriform 5. Thappa DM. Essentials in Dermatology. 2nd ed. New Delhi: Jaypee
    Brothers Medical Publishers Pvt. Ltd; 2009. p. 43‑56.
    lesions on the contralateral dermatome: A diagnostic dilemma.’
    6. Koh MJ, Seah PP, Teo RY. Zosteriform herpes simplex. Singapore Med
    by Udayashankar C et al.[1] They concluded that the patient had J 2008;49:e59‑60.
    recurrence of zosteriform lesions on the left T4‑5 dermatomes,
    Access this article online
    of which T4 is the corresponding contralateral dermatome to
    the previous episode and had a diagnostic dilemma as they did Quick Response Code:

    not have the laboratory evidence for the causative organism, Website: www.idoj.in
    which could be either herpes simplex or varicella zoster virus.
    DOI:
    10.4103/2229-5178.120643
    We completely agree with the importance of identifying the
    causative organism as proper diagnosis will lead to more
    accurate therapy.[1] It is important to distinguish between
    these two viruses with the advent of antiviral drugs and
    isolation procedures.[2]
    A cases series of Piezogenic
    We would like to add a clinical clue, which could possibly help
    in differentiating between these two conditions. We would like to pedal papules
    point out an important clinical observation by many authors that
    the vesicles of herpes simplex are uniform in size in contrast Sir,
    to the vesicles seen in herpes zoster, which vary in size.[3‑5] In Piezogenic pedal papules are uncommon skin‑colored
    other words, vesicles of herpes simplex are uniform within a asymptomatic papules that are observed more frequently
    cluster.[3] A later recurrence proves the diagnosis of simplex.[4,6] among healthy adults and children.[1] Four patients who initially
    Koh MJ et al. reported a 65‑year‑old man who presented with presented with thick, skin‑colored papules on the feet that
    recurrent episodes of a “zosteriform eruption”. He was initially became pronounced after physical activity and standing were
    clinically diagnosed and treated for recurrent herpes zoster, diagnosed with piezogenic pedal papules. We report these
    but was subsequently found to have recurrent herpes simplex cases due to its rarity.
    virus type 2 after laboratory investigations.[6]
    CASE 1
    With the above clinical clue it is more likely, from the clinical
    features and the photograph, that this was a case of zosteriform A 19‑year‑old female admitted for numerous soft and round
    herpes simplex (uniform vesicles within a cluster). lesions on the heels that became prominent with standing.
    The lesions initially appeared on the lateral and posterior parts
    Sanath Aithal, Sheela Kuruvila, Satyaki Ganguly of both feet, and their size and number continued to increase
    Department of Dermatology, Venereology and Leprosy, over time. Standing and walking resulted in a continuous pain
    Pondicherry Institute of Medical Sciences, Pondicherry, India in the heels that gradually intensified. The pain subsided with
    Address for correspondence: Dr. Satyaki Ganguly, the cessation of standing and walking, and also by applying
    Department of Dermatology, Venereology and Leprosy, pressure in areas of the feet other than the heels. The patient
    Pondicherry Institute of Medical Sciences, had no previous history of feet injuries and of excessive or
    Pondicherry – 605 014, India. continuous pressure exerted on the feet (due to factors such
    E‑mail: satyakiganguly@yahoo.co.in as excessive weight, jumping, etc.).
    REFERENCES
    When no pressure was applied to the lesions, they presented as
    1. Udayashankar C, Oudeacoumar P, Nath AK. Recurrence of zosteriform soft, round, skin‑colored and about 0.1-0.4 cm diameter papules
    lesions on the contralateral dermatome: A diagnostic dilemma. Indian on the outer edges of the heels. Under pressure, the lesions
    Indian Dermatology Online Journal - October-December 2013 - Volume 4 - Issue 4 369

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