Herpes zoster in diverse immunocompromised populations: A case series

Herpes zoster (HZ), caused by reactivation of the varicella-zoster virus, is often linked to immunosuppression and can present atypically. This case series describes nine patients: five human immunodeficiency virus (HIV)-positive adults with reduced CD4 counts (380-458 cells/mm³) and two children on immunosuppressive therapy for leukemia. Adult cases showed severe pain and lesions across multiple dermatomes, with facial or thoracic involvement. Two had high-risk sexual behavior, and one had recurrent episodes. The children presented with severe pain and vesicular lesions; one had noncontiguous dermatomal involvement. The findings underscore the role of immunosuppression, particularly HIV and leukemia therapy, in atypical HZ presentations.