Abstract
Herpes zoster (HZ) involving more than two separate dermatomes simultaneously is known as HZ duplex. We present a patient with acute pain from HZ duplex who was treated with an early nerve block. A 61-year-old man presented with diffuse edematous erythema on the left side of his hip (S3 dermatome) and a rash on his right leg (L3 dermatome). One week earlier, he had severe pain in his right leg. Since severe pain persisted despite the administration of acyclovir and analgesics, he was referred to us for treatment of the pain. Both the right leg (L3) with severe pain and the hip (S3) with a severe skin eruption were considered at risk for progression to postherpetic neuralgia (PHN). Continuous epidural analgesia (at spinal level L4/5) was performed and relieved the pain immediately. We conclude that early nerve block may not only have relieved the acute pain in the right leg but also prevented the progression to PHN.
