Herpes Zoster Dermatitis after Corneal Collagen Cross-Linking with Riboflavin: A Case Report

Abstract

A middle-aged female presented with complaints of decreased vision in both eyes OD (right eye) > OS (left eye), since 6 months, and eye rubbing. Due to steep keratometry readings on an automated keratometer, pentacam was done, and the findings were suggestive of keratoconus in OD and formefruste keratoconus in OS. As best corrected visual acuity (BCVA) decreased only since 6 months and pentacam readings were suggestive of keratoconus, the patient was treated with corneal collagen cross-linking with riboflavin (C3R) in OD, to halt the progression. On post-op day 5, the patient presented with erythema, small papulovesicular lesions over the right half of the face and forehead, suggestive of herpetic skin lesions. She was prescribed topical eye drops for post-C3R haze and oral acyclovir for skin lesions, which were regressed within 1 week. Early diagnosis and appropriate treatment of herpes zoster dermatitis prevent worsening of signs and decrease further risk of herpetic keratitis and associated complications. Thus in this case, ultraviolet (UV)-A irradiation acted as a trigger for herpes zoster virus reactivation.

Keywords

• corneal collagen cross-linking
• dermatome
• herpetic rash
• uv-a irradiation