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

Kim, Hong Il; Hwang, So Min; Ahn, Sung Min; Lim, Kwang Ryeol; Jung, Yong Hui; Song, Jennifer K; Jeong, Jae Yong

doi:2012.13.1.68

Arch Craniofac Surg > Volume 13(1); 2012 > Article

Case Report

Archives of Craniofacial Surgery 2012;13(1):68-71.
DOI: https://doi.org/10.7181/acfs.2012.13.1.68

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

Hong Il Kim, So Min Hwang, Sung Min Ahn, Kwang Ryeol Lim, Yong Hui Jung, Jennifer K Song, Jae Yong Jeong

¹Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital, Busan, Korea. psasm@naver.com
²PLUS Aesthetic Plastic Surgery Clinic, Daejeon, Korea.

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.

Keywords: Eczema herpeticum; Corrective rhinoplasty