Arch Craniofac Surg.  2012 Oct;13(2):147-150. 10.7181/acfs.2012.13.2.147.

Necrotizing Fasciitis of Nose Skin Following Herpes Zoster

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea. pssroh@jbnu.ac.kr

Abstract

PURPOSE
Varicella-zoster virus (VZV) infection is a common childhood disease. However, old and immune compromised patients are also at risk. Necrotizing fasciitis is a life threatening infection of the subcutaneous tissues, rapidly extending along the fascial planes. It is associated with a significant mortality rate, reported between 20% and 50%, and is therefore regarded as a surgical emergency. The authors treated a patient, who developed skin necrosis of her nose and left hemifacial area, following VZV infection. There are few literatures concerning this case; therefore, we present a rare case with review of literature.
METHODS
A 39-year-old woman had shown a localized, painful, multiple bullae and eschar formation in her nose and left hemifacial area for several days. Her skin lesion had rapidly worsened in size and morphology.
RESULTS
We diagnosed her as a necrotizing fasciitis, following herpes zoster, and then we performed a debridement of necrotic tissue and took a full thickness skin graft on her nose and left hemifacial area. Now, she was followed up with acceptable aesthetic result after 6 months.
CONCLUSION
Secondary bacterial skin infection following VZV, can cause a result in a higher risk of complications. Among the complication, a necrotizing fasciitis of the head and neck is uncommon, and involvement of the nose is even more rare. Through this uncommon case report, we intend to emphasize the fact that early diagnosis of necrotizing fasciitis is very important, since it frequently necessitates surgical treatment which improves morbidity and leads to good recovery.

Keyword

Varicella-zoster virus; Herpes zoster; Necrotizing fasciitis

MeSH Terms

Adult
Blister
Debridement
Early Diagnosis
Emergencies
Fasciitis, Necrotizing
Female
Head
Herpes Zoster
Herpesvirus 3, Human
Humans
Neck
Necrosis
Nose
Skin
Subcutaneous Tissue
Transplants
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