Postherpetic Pruritus: A Potential Complication of Herpes Zoster Virus Infection

Postherpetic pruritus is an uncommon adverse sequela of Varicella zoster infection. It can present with or without prior postherpetic neuralgia. A 57-year-old woman who developed persistent postherpetic pruritus following a Varicella zoster infection, affecting the skin between her right thoracic fifth to eighth dermatomes is described; she did not have postherpetic neuralgia. Her condition did not improve with systemic antiviral or gabapentin treatment; however, nine years later, she exhibited significant relief after two months of acyclovir 800 mg five times daily. In summary, postherpetic pruritus is a potential complication that can occur alone or in combination with postherpetic neuralgia. Some patients with postherpetic pruritus have a treatment-refractory disease. However, other patients respond to gabapentin; yet, long-term interventions may be necessary for persistent pruritus. Our patient's pruritus significantly improved after restarting systemic antiviral therapy.