Discussion
The concern about the association between the COVID and HZ was
raised[2, 3]. The clinical manifestations of COVID-19 were detected
in asymptomatic cases to severe clinical symptoms with a major impact on
the respiratory system[5]. Furthermore, HZ may appear in completely
asymptomatic COVID-19 patients [6].
Recently, few reports of reactivation of herpes zoster during Covid-19
infection were published.
Elsaie et al. reported a HZ lesion in 2 patients with COVID-19 with mild
or no respiratory symptoms and no history of contact with known or
suspected COVID19 cases[3].
Desai et al reported unilateral vesicular painful rashes along the
dermatomes T-11-12 in a patient with COVID-19 infection. The lesions
were detected 6 weeks after the COVID-19 symptoms started[2].
However, we detected the HZ lesion 10 days after COVID-19 symptoms
started.
We believe that few reports of herpes zoster in COVID-19 patients are
due to many factors as a full evaluation of patients with COVID-19 in
terms of oral mucosa is not commonly performed due to the severity of
the diseases. In addition, it may be difficult for clinicians to detect
those lesions in patients without painful symptoms.
Increased incidence of HZ during COVID-19 outbreak may be related to the
intense stress during the infection and the altered immunity during the
pandemic[7]. Biopsy wasn’t performed on our patient however we
recommend further research in the form of well-designed studies to be
conducted to establish whether COVID-19 raises the risk of HZ. Health
practitioners should be concerned about the probably risen incidence of
HZ during COVID-19 pandemic and consider appropriate therapeutic and
protective measures against it.
CONFLICT OF INTEREST: The authors declare no conflicts of
interest.
Sources of funding for your research: There are no funding
sources or sponsors related to the present work.
Patient’s consent: Written informed consent was obtained from
the patient for publication of this case report and accompanying images.
Authors contribution: All authors had a role in writing and
revising this manuscript