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Case Reports
. 2025 Apr 7;17(4):e81825.
doi: 10.7759/cureus.81825. eCollection 2025 Apr.

Herpes Zoster Without Vesicles: An Atypical Linear Erythematous Plaque on the Inner Thigh

Khadijah H Muzaffar  1 , Abdullah Albadri  2
Affiliations
Case Reports

Herpes Zoster Without Vesicles: An Atypical Linear Erythematous Plaque on the Inner Thigh

Khadijah H Muzaffar et al. Cureus. .

Abstract

Herpes zoster (HZ), caused by the reactivation of the varicella-zoster virus (VZV), typically presents with a painful, vesicular rash along a dermatomal distribution. This case reports an unusual presentation in a 44-year-old female with hypothyroidism and urticaria, who presented with a solitary, linear erythematous plaque on the inner thigh, associated with burning pain. Initial topical treatments were ineffective, but prompt antiviral therapy with acyclovir led to complete resolution within six weeks. The case highlights the diagnostic challenges posed by atypical presentations of HZ and the importance of early diagnosis and treatment to prevent complications, such as postherpetic neuralgia. It also emphasizes the need to consider HZ in differential diagnoses even in the absence of typical vesicular eruptions to facilitate timely intervention and improved patient outcomes.

Keywords: derm path; dermatomes; herpes zoster (hz); skin disease/dermatology; varicella-zoster virus (vzv).

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board - Jeddah Ministry of Health issued approval A01988. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. A linear erythematous and edematous plaque, on an erythematous background, following a dermatomal distribution on the inner left thigh
See this image and copyright information in PMC

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