Herpes zoster in Child
See also in: Cellulitis DDx,Anogenital,Hair and Scalp,Oral Mucosal LesionAlerts and Notices
Synopsis
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.
Codes
ICD10CM:B02.9 – Zoster without complications
SNOMEDCT:
4740000 – Zoster
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- 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
- Folliculitis
- Herpangina
- Insect bites
- Other poxviruses (cowpox, monkeypox)
- Pyoderma gangrenosum
- Primary varicella infection and disseminated varicella
- Urticaria
- Bullous fixed drug eruption
- Eczema herpeticum
- Vasculitis
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:04/12/2018
Last Updated:11/14/2019
Last Updated:11/14/2019
Herpes zoster in Child
See also in: Cellulitis DDx,Anogenital,Hair and Scalp,Oral Mucosal Lesion