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Herpes zoster affecting the lower extremity.

BACKGROUND The classic appearance and manifestations of herpes zoster are a unilateral dermatomal pattern of vesicles on an erythematous base. There are very few reported pedal cases of herpes zoster with resulting postherpetic neuralgia (PHN), which is described as subsequent pain experienced after acute viral infection and resolution of the skin rash.Most commonly, herpes zoster will affect the thoracic region, but 2 cases of herpes zoster on the lower extremity were seen at the authors’ clinic. Overall, the treatment plan is approached on an individualized basis according to each patient, with the goal of treating the acute viral infection, alleviating pain, and alleviating PHN, if present. In this article, the authors discuss 2 cases of lower extremity herpes zoster with resultant mild PHN. The treatment regimens included a combination of oral valacyclovir, topical acyclovir, oxycodone/acetaminophen, transdermal lidocaine, and pregabalin.