Herpes zoster in età pediatrica

Herpes zoster is uncommon in pediatric age and little is known about its frequency. A retrospective study aimed to evaluate the frequency of herpes zoster among patients attending the Dermatology Clinic of the University of Catania during the period January 1987 - December 1999 was performed. Inclusion criteria were the clinical aspect of the lesions, a past medical history positive for varicella infection and negative for relapsing vesicles eruptions in the same site, a positive Tzanck smear, presence of anti-HZV and absence of anti-herpes simplex virus 1 and herpes simplex virus 2 antibodies. In the time considered 15 children (3 M and 12 F; mean age: 9.4 years, range 2-15 years) with herpes zoster were observed. The most frequent areas of involvement were the thoracic dermatomes (5 cases), followed by the thoraco-brachial (3 cases), lumbar (3 cases), genito-crural (2 cases), ophthalmic-maxillary (1 case), and cervico-facial (1 case) dermatomes. Clinically, skin lesions appeared as unilateral, grouped, tense vesicles on an erythematous base with a dermatomal distribution, sometimes restricted to a limited area. Eleven patients reported mild symptoms and four were asymptomatic. There were no cases of lymphoproliferative disorders or immunodeficiency. All patients underwent therapy with oral acyclovir (20 mg/kg 4 times a day for 1 week). On the basis of the relative frequency observed, the true incidence of childhood herpes zoster could be underestimated. The benign course of the disease in children is remarked.