Herpes Labialis with Opthalmicus- A Rare Dual Phenomenon

Back ground: Herpes zoster, or shingles, is a painful viral infection caused by the reactivation of the varicella-zoster virus (VZV), the same virus as chickenpox, resulting in a blistering rash, often on one side of the body or face, accompanied by burning pain, tingling, and itching, which can develop into postherpetic pain. It typically appears as a band of fluid-filled blisters that crust over in a few weeks, with early symptoms including headache, fever, and fatigue. Herpes labialis appears on lips and ophthalmicus involves eyes, usually one sided but simultaneous involvement is uncommon. Treatment with antiviral medications can reduce severity, and vaccination is available to prevent it. Case Report: A sixty -year-old male patient, a known case of any chronic hepatitis B, on antiviral treatment, presented with acute pain on lips with tingling sensation, for last one week. It was associated with malaise, feverishness, anorexia and vomiting. After, a gap of three days, herpetic vesicular lesions appeared on the lips. The dermatologist opinion was taken who confirmed it to be herpes labialis and started on oral and topical antiviral treatment, along with anti-inflammatory drugs. The patient within next fourty eight hours developed vesicular lesions near left eye. It was associated with redness and watering from eye. The ophthalmologist opinion confirmed it to be herpes zoster opthalmicus. The abdominal, cardio-vascular, respiratory, neurological examination was essentially normal. The already prescribed treatment in form of antiviral and anti-inflammatory was continued. The herpetic lesions both along eye and lips crusted and ultimately healed completely. The patient was discharged under hemodynamically stable condition. Conclusion: Herpes zoster is commonly seen, especially in immunocompromised and elderly patients. It commonly affects thoracic area but other areas like herpes labialis, or eye involvement can also occur but simultaneous involvement is uncommon.