Lamees Mahmood Malik, Nadia Ali Azfar, Abdur Rahim Khan, Ijaz Hussain, Muhammad Jahangir.
Herpes zoster in children.
J Pak Assoc Derma Jan ;23(3):267-71.

Objective To study the epidemiology and clinical features of childhood herpes zoster. Patients and methods The study was carried out from March 2008 till February 2012. Forty two cases of herpes zoster in children less than 12 years of age were enrolled from the outpatient departments of Lahore General Hospital and Jinnah Hospital Lahore. Patients were subjected to detailed history, physical examination and relevant investigations. Results Out of 42 patients with herpes zoster, 57.1 % were males and 42.9 % were females. The mean age was 8 years with an age range of 18 days to 12 years. In most patients a single dermatome was involved (69%) and thoracic dermatome was involved in the majority (40.4%). The most common symptom was pruritus in 52%, followed by pain in 12%. A positive history of previous exposure to varicella was present in 31% patients only, and out of these 61% were exposed before the age of two years. Six patients gave history of chickenpox in mother during pregnancy. Majority of patients i.e. 83.3% showed no evidence of immunosuppression on history, examination and investigations. Three patients were anti-HCV positive (7.1%), two (4.6%) had tuberculosis, one (2.3%) patient was taking steroids and one (2.3%) was diagnosed as leukemia. Conclusion Most of the children with herpes zoster had no obvious evidence of immunosuppression. History of previous exposure to varicella was found in only 31% with majority being exposed below two years of age. Herpes zoster is a relatively mild disease in children with pruritus being the main symptom in 52% and pain occurred in only 12% of cases.

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