[Herpes zoster : vaccination and management of satellite lesions in immunocompromised patients]

Shingles, also termed herpes zoster (HZ), is due to the reactivation of the varicella zoster virus (VZV) in a dorsal root nerve ganglion with an intra-axonal passage of the virus to a predetermined dermatome. The risk of HZ increases with age, as well as the morbidity risks. The most feared complication is post-herpetic neuralgia, defined as persisting pain sensations three months after the resolution of the skin lesions. Those risks are even more important in the immunocompromised patient. Currently a recombinant vaccine against HZ reactivation is available with an excellent safety profile. It has demonstrated a very high vaccine protection achieving 97 % for preventing HZ and its complications. A patient presented severe facial HZ with a large number of HZ satellite lesions disseminated over the entire tegumentum. These satellite lesions are a reliable clinical marker for HZ with a high risk for complications. This case underlines the risk of morbidity in the elderly immunocompromised patient as well the fact that HZ is a vaccine preventable disease, currently reimbursed, but not well-known.