ORIGINAL PAPER Herpes Zoster in children: Evaluation of the sixty cases HamzaAktas¸ 1 | Semahat A. Erdal 2 | Ulas¸Güvenç 3 1 Clinic of Dermatology, Private Sultans's Hospital, Diyarbakır, Turkey 2 Clinic of Dermatology, Health Sciences University, Gazi Yas¸argil Education and Research Hospital, Diyarbakır, Turkey 3 Clinic of Dermatology, Mersin Medical Park Hospital, Mersin, Turkey Correspondence Hamza Aktas¸, Selahattin Eyyubi Mahallesi, Turgut Özal Blv. No: 50, 21080 Ba glar/ Diyarbakır. Email: drhamza_aktas@hotmail.com Abstract Herpes Zoster (HZ), caused by the reactivation of the latent Varicella Zoster Virus infection is a disease that may rarely develop in childhood. HZ is considered to be a disease of adult, but recent reports show an increase in the number of cases in child- hood. This study was designed to evaluate the demographic and clinical features of children with HZ. Data from patients under 18 years of age that were diagnosed with HZ at two different dermatology outpatient clinics were retrospectively evaluated between October 2012 and December 2018. Out of 60 cases enrolled in the study, 37 were male and 23 were female. The mean age of patients was 8 ± 4.93 years. Of all the cases, 46 had a history of chickenpox. Three patients had been vaccinated against chickenpox. Itching, observed in 48 subjects, was the most common symptom, while 38 subjects complained of pain. Acyclovir was prescribed as antiviral therapy in 33 cases. None of the cases showed any complication. HZ may occur in healthy chil- dren without any immunosuppression, too. Pain in children is less common than in adults whereas, itching is more frequent. Complications are rare in these subjects. KEYWORDS antiviral therapy, childhood, complication, healthy children, Herpes Zoster, varicella zoster virus 1 | INTRODUCTION Herpes Zoster (HZ) is caused by the reactivation of varicella zoster virus (VZV) that remains latent in the dorsal root ganglia following pri- mary varicella or chickenpox infection. It is a localized disease that is characterized by a clinically erythematous vesicular rash (Krafchik & Tellier, 2006). HZ is commonly observed in adults, but it can also be encountered in children and adolescents with immunological conditions who have had chickenpox early in life (Krafchik & Tellier, 2006). In recent years, there have been reports of HZ developed in healthy children (Baba, Yabuuchi, Takahashi, & Ogra, 1986; Katakam, Kiran, & Kumar, 2016). About 2% of the patients that are exposed to VZV in utero carry vari- cella subclinically and are prone to the risk of HZ infection following birth (Sauve & Leung, 2003). Because the varicella vaccine is attenuated, HZ may develop in vac- cinated individuals as well. The incidence of HZ after chickenpox is 20–63/100,000 per year, and 14/100,000 per year in vaccinated cases. Immune deficiency, immunosuppressive treatment, and advanced age have been associated with increased risk of HZ infection. It is rarely seen in individuals less than 10 years old. The disease involves the cer- vical and sacral regions in children, lower thoracic, upper lumbar, and trigeminal nerves in adults (Leung, Robson, & Leong, 2006). This retrospective study aimed to determine the clinical character- istics, concomitant diseases, treatment modalities, and complications in children that were diagnosed with and treated for HZ. 2 | MATERIALS AND METHODS Patients aged less than 18 years old who were diagnosed with HZ at two dermatology outpatient clinics between October 2012 and December 2018 were evaluated retrospectively. A standard registra- tion form was generated with all the information about the patients to be used in both units. Information regarding age, sex, involved derma- tome, history of chickenpox and history of varicella vaccine, presence Received: 10 June 2019 Revised: 4 September 2019 Accepted: 11 September 2019 DOI: 10.1111/dth.13087 Dermatologic Therapy. 2019;e13087. wileyonlinelibrary.com/journal/dth © 2019 Wiley Periodicals, Inc. 1 of 5 https://doi.org/10.1111/dth.13087