Herpes zoster opthalmicus in geriatric with malnutrition A case report

Background: Herpes zoster opthalmicus (shingles) is a reactivation of latent Varicella Zoster Virus (VZV) affecting the ophthalmic branch of the trigeminal nerve. One of the risk factors that can cause reactivation of shingles are aging and immunosuppression conditions such as malnutrition. Case: We reported a case of 75 years old patient with stabbing pain dan stinging sensation on the left forehead with a Visual Analog Scale (VAS) score of 3. Body mass index was calculated and showed underweight status (malnutrition). Dermatological examination showed erythematous, well-defined macules to patch, topped with a blackish-brown crust, with multiple erosions at some part over the left frontal region, superior palpebra and the parietal area (following the dermatome of the ophthalmic branch of the trigeminal nerve). The patient was given oral acyclovir, oral methylprednisolone, gabapentin, amitriptyline and vitamin B. The lesions were compressed with saline solution. The patient was also given high calories and protein intake to fix nutrition status. These interventions showed significant improvement of the lesions. Discussion: The incidence and severity of shingles increases in geriatric patients. This can also be explained because aging is associated with a greater susceptibility of nutritional deficiency which can suppress specific and non-specific immunity. Nutritional conditions in herpes zoster patients can influence the severity and incidence of postherpetic neuralgia as well. Conclusion: The purpose of reporting this case is to discuss nutritional status is an important factor that must be considered in dealing with the incidence of herpes zoster as to reduce the incidence of postherpetic neuralgia.