What is bilateral herpes zoster?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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On rare occasions, herpes zoster manifests bilaterally. Bilateral presentations should always raise concern for disseminated disease (and immunocompromise) or for alternate diagnosis, specifically for herpes simplex.

In cases of bilateral zoster, it is not unusual for 1 or 2 adjacent dermatomes to be involved. Unlike examples of multiple dermatomal involvement in unilateral disease (see above), involvement in adjacent dermatomes is not typically a sign of underlying disease (eg, malignancy).

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