Shingles on the Big Toe

Abstract

Mehmet Sinan Saricicek and Ali Taylan Saricicek

Shingles occurs after reactivation of latent Varicella zoster virus (VZV) in the dorsal root ganglion. Usually, chickenpox is primary infection that occurs in childhood. After primary infection, VZV can be latent in neural tissue and can be reactive spontaneously or because of various risk factors. The most common risk factors are age >50 years, immunosuppression, infection, and mental stress. Symptoms appear in 3 phases: pre-eruptive, acute exudative, and chronic. Symptoms usually start in the pre-eruptive phase. Typically, patients present with painful or pruritic band-like vesicular lesions that do not cross the midline of the body. The most common site of shingles is the thoracic area. In this case report, we describe the atypical presentation of shingles with rare dermatomal involvement in a 55-year-old female patient who had a history of a significant immunocompromised state.

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