Arch Craniofac Surg.  2012 Apr;13(1):68-71. 10.7181/acfs.2012.13.1.68.

Herpes Simplex Virus Infection after Corrective Rhinoplasty through External Approach: Two Case Reports

• Kim HI
• Hwang SM
• Ahn SM
• Lim KR
• Jung YH
• Song JK
• Jeong JY

• KMID: 2116861
• DOI: http://doi.org/10.7181/acfs.2012.13.1.68

Abstract

PURPOSE
Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty.
METHODS
First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied.
RESULTS
Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period.
CONCLUSION
Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

Keyword

Eczema herpeticum; Corrective rhinoplasty

MeSH Terms

Bacterial Infections
Bandages
Communicable Diseases
Diagnostic Errors
Early Diagnosis
Erythema
Female
Follow-Up Studies
Ganglia
Herpes Simplex
Humans
Kaposi Varicelliform Eruption
Methylmethacrylates
Nose
Osteotomy
Polystyrenes
Rhinoplasty
Simplexvirus
Skin
Surgery, Plastic
Trigeminal Nerve
Ulcer
Viruses
Young Adult
Methylmethacrylates
Polystyrenes