Disseminated Herpes Zoster in an Elderly Woman: A Rare Clinical Manifestation

Introduction: Disseminated herpes zoster (DHZ) is a severe complication of varicella-zoster virus (VZV) infection. This atypical form of herpes zoster occurs in 10–40% of immunocompromised individuals and may involve visceral organs. To date, studies reporting on DHZ remain limited. Therefore, this case report aims to describe the clinical manifestations of disseminated herpes zoster in a 64-year-old woman. Case Report: A 64-year-old woman was referred from the intensive care unit (ICU) on August 12th, 2026, due to progressively spreading vesicular lesions. Previously, on August 11th, 2026, the patient had developed grouped vesicles on the left arm extending to the medial region of the left elbow, which were diagnosed as herpes zoster. The patient also had a history of malignancy, specifically high-grade diffuse large B-cell lymphoma (DLBCL), confirmed by immunohistochemical examination. Dermatological examination showed multiple grouped vesicles distributed along a dermatome on the left medial brachial region, as well as discrete vesicles in the thoracic region and contralateral brachial region. These findings supported the diagnosis of disseminated herpes zoster. The patient received oral acyclovir at a dose of 800 mg five times daily for seven days, along with topical therapy and 0.9% sodium chloride (NaCl) compresses applied to the exudative lesions. Conclusion: This case describes the clinical manifestations of disseminated herpes zoster in a 64-year-old woman. It highlights the diagnostic challenges posed by disseminated herpes zoster in immunocompromised patients. Identification of this condition requires careful evaluation of lesion morphology, distribution, and clinical progression.