Disseminated Herpes Zoster in an Apparently Healthy Middle-Aged Woman

Herpes zoster is a characteristic dermatomal maculovesicular rash that results from reactivation of varicella-zoster virus (VZV). Dissemination, or widespread distribution of vesicular lesions beyond the limits of the primarily involved dermatome, occurs almost exclusively in individuals with severe underlying immunodeficiency, such as malignancy, human immunodeficiency virus, and advanced age. Waning cell-mediated immunity is thought to be the final common pathway permitting reactivation and dissemination. Here, however, we present a case of disseminated herpes zoster (DHZ) that occurred in an apparently immunocompetent patient without any traditional risk factors.