반대편 눈확위신경 영역에 재발된 대상포진 1예

An 85-year old female patient visited our pain clinic because of pin pricking pain and allodynia on the left forehead area for 2 days. Vesicular eruptions were seen along the left supraorbital nerve distribution. She experienced similar pain and eruptions on the contralateral forehead, the supraorbital counter area, 8 years previous. She had been taking antihypertensive medications for 15 years. She also had suffered from diabetes mellitus. She received a total hysterectomy and anterior posterior colporrhapy due to procidentia uteri and severe cystocele and rectocele. She had been treated intermittently for back pain due to advanced osteoarthritis and spondylosis. She was treated with famciclovir and triamcinolone acetonide with daily stellate ganglion block and supraorbital nerve block. Nortriptyline (a tricyclic antidepressant) and midazolam was prescribed to relieve pain and difficulty in sleeping. After 3 days, all treatment was ended because it was impossible to assess the severity of pain due to the senile psychosis of the patient. She eventually expired after 2 months. We report this case because it is rare for herpes zoster to recur, and particularly on the contralateral counter area.