Genital Herpes Zoster: A Report of a Rare Case

Herpes zoster (HZ), caused by the reactivation of the varicella-zoster virus (VZV), typically presents as a unilateral vesicular rash in a dermatomal pattern. Its occurrence in the genital area is rare and often misdiagnosed. We report the case of a 51-year-old woman who presented with sudden vulvar pain and burning, without a history of immunodeficiency or sexually transmitted infections. Examination revealed unilateral vesicular lesions on the left labium majus, perianal area, medial thigh, and gluteal region along the second sacral (S2) and third sacral (S3) dermatomes. Polymerase chain reaction (PCR) confirmed VZV and ruled out herpes simplex virus (HSV). The patient was treated with brivudine, mupirocin, and analgesics, resulting in a complete resolution of symptoms. This case highlights the need to consider HZ in the differential diagnosis of genital lesions. Early recognition and treatment of atypical presentations can prevent complications and improve patient outcomes.