Herpes zoster in seven disparate dermatomes (zoster multiplex): report of a case and review of the literature

J Am Acad Dermatol. 1999 May;40(5 Pt 2):868-9. doi: 10.1053/jd.1999.v40.a96944.


Noncontiguous multidermatomal herpes zoster is very rare in both immunocompetent and immunocompromised persons. Most of the reported cases have been limited to 2 noncontiguous dermatomes. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending on whether one or both halves of the body are involved. Granulomatous dermatitis at sites of herpes zoster scars, a rare isotopic response, has only been reported in persons with contiguous dermatomes of zoster. We describe an immunocompromised patient who developed herpes zoster in 7 disparate dermatomes. Three months after resolution of the zoster, the patient developed a granulomatous dermatitis in a zosteriform distribution at the sites of previous infection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • 2-Aminopurine / analogs & derivatives
  • 2-Aminopurine / therapeutic use
  • Acyclovir / therapeutic use
  • Aged
  • Antiviral Agents / therapeutic use*
  • Dermatitis / etiology
  • Dermatitis / pathology
  • Famciclovir
  • Granuloma / etiology
  • Granuloma / pathology
  • Herpes Zoster / complications
  • Herpes Zoster / drug therapy
  • Herpes Zoster / pathology*
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation
  • Male
  • Prodrugs / therapeutic use
  • Skin Diseases, Viral / complications
  • Skin Diseases, Viral / drug therapy
  • Skin Diseases, Viral / pathology*


  • Antiviral Agents
  • Prodrugs
  • 2-Aminopurine
  • Famciclovir
  • Acyclovir