Herpes zoster in Child
Although the onset of cutaneous zoster in adults typically involves a 1-3 day prodrome of burning pain or tingling in the affected dermatome, this is rarely observed in children. Postherpetic neuralgia is also rare in children. Other less frequently encountered post-zoster sequelae include herpes zoster granulomatous dermatitis.
If it occurs, zoster encephalitis usually appears in the first 2 weeks after the onset of lesions and has a 10%-20% mortality rate. Disseminated zoster occurs 5-10 days after the onset of dermatomal disease. It is defined as more than 20 lesions outside the initial dermatome of involvement.
B02.9 – Zoster without complications
4740000 – Zoster
- Herpes simplex virus infection occurring within a dermatomal distribution is the primary differential diagnosis. Serology, viral culture, or polymerase chain reaction (PCR) may be necessary to distinguish this diagnosis from zoster.
- Allergic contact dermatitis may present as a well-defined vesicular plaque. A dermatomal distribution suggests zoster.
- Molluscum contagiosum, when inflamed, can be confused with varicella-zoster. Cases are typically of longer duration, and VZV PCR studies are negative. The presence of coexisting noninflamed molluscum lesions is a helpful diagnostic clue.
- Cellulitis or erysipelas
- Insect bites
- Other poxviruses (cowpox, monkeypox)
- Pyoderma gangrenosum
- Primary varicella infection and disseminated varicella
- Bullous fixed drug eruption
- Eczema herpeticum