Shingles on the face: Particularities in diabetics

The aim of our work is to illustrate the clinical aspects of shingles on the face in diabetics and to determinate its particularities. We conducted a retrospective study over a period of 5 years (2019–2023). Epidemiological, clinical and therapeutic data were collected from the register of patients who had been hospitalized in our department. Our study is based on the cases of 10 patients. The mean age of our patients was 68 years old (55–88 years old). Males predominated (sex ratio 4). In pathological history, all patients were balanced and non-complicated type 2 diabetics on oral antidiabetics in 5 cases and on insulin in 5 cases. The main symtoms were pruritic facial rash, insomniac pain, burning sensation, evolving in non-febrile context with otalgia and peripheral facial paralysis in 3 cases. All patients had unilateral pruritic, painful, non-infected and grape like skin vesicles, affecting forehead and eyelids in 7 cases, and affecting Ramsey-Hunt zone in 3 cases with peripheral facial paralysis grade 3. Treatment was based on antiviral, analgesic, local care with eosin and fusidic acid cream in all cases associated with local ophthalmic treatment in cases of ophthalmic shingles and with corticosteroid therapy, vasodilator, vitamin therapy and facial rehabilitation in cases of Ramsey-Hunt syndrome. All patients had clinical improvement despite persistent pain. Shingles is common in immunocompromised patients including diabetes. Early diagnosis is crucial to avoid debilitating nerve complications such as post-herpetic neuralgia.