TITLE:
Herpes Zoster in Childhood
AUTHORS:
Alexander K. C. Leung, Benjamin Barankin
KEYWORDS:
Varicella-Zoster Virus, Reactivation, Vesicular Eruption, Dermatome, Acyclovir
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.5 No.1,
March
6,
2015
ABSTRACT: Herpes zoster is caused by
reactivation of latent varicella-zoster virus that resides in a dorsal root
ganglion. Herpes zoster can develop at any time after a primary infection or
varicella vaccination. The incidence among children is approximately 110 per
100,000 person-years. Clinically, herpes zoster is characterized by a painful,
unilateral vesicular eruption in a restricted dermatomal distribution. In young
children, herpes zoster has a predilection for areas supplied by the cervical
and sacral dermatomes. Herpes zoster tends to be milder in children than that
in adults. Also, vaccine-associated herpes zoster is milder than herpes zoster
after wild-type varicella. The diagnosis of herpes zoster is mainly made
clinically, based on a distinct clinical appearance. The most common
complications are secondary bacterial infection, depigmentation, and scarring.
Chickenpox may develop in susceptible individuals exposed to herpes zoster. Oral
acyclovir should be considered for uncomplicated herpes zoster in
immunocompetent children. Intravenous acyclovir is the treatment of choice for
immunocompromised children who are at risk for disseminated disease. The
medication should be administered ideally within 72 hours of rash onset.