Risk Factors and Clinical Features of Herpes Zoster in Children: A Case Series

Herpes zoster (HZ) is an infectious disease resulting from the reactivation of the varicella-zoster virus (VZV), which remains latent in ganglionic neurons after primary varicella infection. The occurrence of HZ in the pediatric population is relatively uncommon, and identifying risk factors that facilitate VZV reactivation is important. This study presents three cases of children with distinct clinical manifestations of HZ, considering various predisposing factors for disease development. The described patients included a three-year-old boy with a typical form of HZ during maintenance therapy for acute lymphoblastic leukemia (ALL). The second case was a 16-year-old girl with disseminated HZ and a diagnosis of acute myeloid leukemia (AML) who had multiple treatment-related complications. The third patient was an immunocompetent 15-year-old boy with Ramsay Hunt syndrome (RHS). Variables analyzed included immune status, the presence of comorbidities, administered medications, and a history of varicella infection. Based on available literature and case analysis, selected risk factors were discussed, including early childhood varicella infection, acquired immunodeficiencies, and conditions requiring immunosuppressive therapy. This study emphasizes the importance of early identification of at-risk children. Such an approach may facilitate the consideration of preventive strategies and, in the case of symptomatic infection, lead to earlier diagnosis and more effective treatment.