© 2002 by Annals of the Rheumatic Diseases
Unusual and memorable
Case Number 22: An interesting case of herpes zoster in rheumatoid arthritis
Series editor: Gary D Wright
Department of Rheumatology, Royal Victoria Hospital, Grosvenor Road Belfast BT12 6BA, UK
Correspondence to:
Correspondence to:
Dr Meenagh;
garymeenagh@yahoo.co.uk
Keywords: herpes zoster
An 82 year old woman with seronegative rheumatoid arthritis was admitted during a flare in her disease. Since diagnosis five years previously her arthritis had been managed with low dose oral corticosteroids at a dose of 10 mg daily.
Shortly after admission she complained of severe pain on the sole of the left foot. Examination at the time showed a discrete area of vesicular eruption (fig 1
). Oral antiviral treatment (acyclovir) was started for herpes zoster. Within 24 hours she had developed a more extensive zoster rash distributed over the posterior aspect of the left leg from ankle to buttock in the S1/S2 dermatome (fig 2). Symptomatically the neuralgic pain completely settled within two days while the rash persisted for a further few weeks.
[in a new window] Figure 1 Vesicular eruption on the sole of the foot.
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[in a new window] Figure 2 Herpes zoster rash.
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Herpes zoster infection is well documented in patients with rheumatoid arthritis, particularly those
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