Herpes zoster in children

ABSTRACT

The aim of this study was to describe the epidemiology, clinical manifestations, therapy and outcome of herpes zoster in children. The medical records of 21 patients with herpes zoster who were referred to the dermatology clinic between February 2003 and July 2005 were reviewed. The total numbers of patients were 12 males [57.1%] and nine females [42.9%]. Their age ranged between 5 and 14 years. The diagnosis was made depending on history and the clinical manifestation. Aciclovir therapy was given systemically within three days of the onset of the exanthem. Amongst the 21 subjects, eight patients had underlying hematological malignancy in the form of acute lymphoblastic leukemia and these represent the immunocompromised group. The other 13 patients were otherwise healthy [immunocompetent group]. Two children in the immunocompetent group were born to mothers who had varicella during pregnancy [intrauterine] at two and seven months of gestation. The other 11 patients had varicella under the age of four years and herpes zoster 4-8 years later. Among the immunocompromised children only two patients had varicella under the age of four years, they all had varicella before the appearance of malignancy, and all patients in this group had herpes zoster between the age of 9 -14 years. Zoster is a rare disease in childhood. Varicella in early childhood is a risk factor of herpes zoster in immunocompromised and immunocompetent children. Most cases of childhood zoster occur in otherwise healthy children. The appearance of herpes zoster in a young child does not always imply an underlying immunodeficiency or malignancy. The prognosis is generally excellent