Introduction: Shingles is a common disease of the elderly. Presenting as metameric eruptions and possibly affecting the
orofacial sphere, its semiology must be mastered by the dental physician, as the diagnosis is essentially clinical.
Clinical observation: This is a 75-year-old patient with no previous history who had previously consulted dentists for painful,
crusty, left-sided skin eruptions on the hemiface. These were associated with erosions in the left labial area and the tongue.
These lesions appeared to follow the course of the third branch of the trigeminal nerve. Given this picture, the diagnosis of
herpes zoster was accepted and the patient was put on Aciclovir® 200 mg 5 times a day, combined with detersions sessions,
strict hygiene and dietary rules and sun avoidance. The patient subsequently showed a good clinical course.
Discussion: Because of its nerve tropism, herpes zoster is a viral disease that can take on several appearances depending on
the nerve affected, thus confusing the practitioner. When faced with any diagnostic hypothesis, the practitioner should note the
unilateral nature and clinical appearance of lesions in a context of advanced age or debility, or suspect the latter.
Conclusion: Shingles is a rare disease, but it is sufficiently characteristic to be recognized and diagnosed by the practitioner.
The practitioner must keep in mind the master signs of this pathology to avoid falling into possible diagnostic traps.
Bibliography : Dupin N. Varicella and shingles. dermatologic therapeutics, 2005, article 13317.
Huraux J-M, Traité de Virologie Médicale, editions Estem 2003