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Vulvar herpes zoster infection: a rare and challenging diagnosis
  1. Matilde Matos Martins,
  2. Patrícia Ferreira,
  3. Raquel Maciel and
  4. Cristina Costa
  1. Gynaecology and Obstetrics, Centro Hospitalar de Entre o Douro e Vouga EPE, Santa Maria da Feira, Portugal
  1. Correspondence to Dr Matilde Matos Martins; matildemartinsm{at}


A 26-year-old woman under immunosuppression with infliximab due to Crohn’s disease was referred to the gynaecology emergency room with dispersed and coalescing vesicular lesions on the vulvar region extending to the right lower limb involving S2–S3 dermatome, associated with severe pain. Clinical history, physical examination and serological testing was consistent with herpes zoster infection. The patient was treated with valaciclovir for 14 days and cefradine for 7 days (due to the possibility of secondary bacterial infection). Significant symptomatic improvement was noted after 1 week. The 1-year follow-up was unremarkable. According to our knowledge and review of the literature, this is one of the few cases reported of vulvar herpes zoster, especially related to infliximab.

  • genital ulcers
  • dermatology
  • obstetrics
  • gynaecology and fertility
  • Crohn's disease

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  • Contributors MMM and RM examined the patient, made the diagnosis and were responsible for the follow-up. MMM wrote the case report and asked for the patient consent. PF, RM and CC made substantial contributions to the conception, design of the work and revised it critically for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.