Trigeminal herpes zoster causing mandibular osteonecrosis and spontaneous tooth exfoliation

We have described a 60-year-old woman with polymyalgia rheumatica treated initially with prednisone but ultimately with azathioprine and cyclophosphamide. Herpes zoster infection along the mandibular division of the right trigeminal nerve ensued with spontaneous exfoliation of two teeth. She subsequently died. Medical practitioners need to be made aware of this rare complication of a common disease.