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Arch Craniofac Surg > Volume 13(2); 2012 > Article
Archives of Craniofacial Surgery 2012;13(2):147-150.
DOI: https://doi.org/10.7181/acfs.2012.13.2.147   
Necrotizing Fasciitis of Nose Skin Following Herpes Zoster.
Woo Sik Pae, Chung Sang Bae, Si Gyun Roh, Nae Ho Lee, Kyung Moo Yang
Department 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.
Keywords: Varicella-zoster virus; Herpes zoster; Necrotizing fasciitis
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Dept. of Plastic & Reconstructive Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea
Tel: +82-53-200-5681    E-mail: prschoi@gmail.com                

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