title: Atypical Presentation of Herpes Zoster Duplex Bilateralis in a Renal Transplanted Patient.
abstract: Viral infections in renal transplant patients are an important cause of morbidity and mortality. In most cases, the clinical presentation of herpes zoster allows the diagnosis to be made only by history and physical examination. However, patients who are immunosuppressed may have uncommon presentations, and require a high index of suspicion and additional diagnostic testing for proper management. We report a rare presentation of herpes zoster duplex bilateralis involving symmetrical dermatomes over the lower limbs occurring in a woman with a recent history of renal transplantation. The skin lesions were also atypical representing a diagnostic challenge. This infection should be part of differential diagnosis of cutaneous manifestations in organ transplant recipients.
authors.affiliation: Universitary Clinic of Dermatology, Santa Maria Hospital, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. anaisabelgouveia@hotmail.com.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Gouveia
authors.affiliation: Universitary Clinic of Dermatology, Santa Maria Hospital, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. jbcosta@fm.ul.pt.|Dermatology Research Unit, Medicine Faculty, Lisboa University, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. jbcosta@fm.ul.pt.|Microbiology and Tropical Clinic Units, Higiene e Medicina Tropical Institute, Lisboa New University, Lisboa 1349-008, Portugal. jbcosta@fm.ul.pt.
authors.forename: João
authors.initials: J
authors.lastname: Borges-Costa
authors.affiliation: Universitary Clinic of Dermatology, Santa Maria Hospital, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. soaresdealmeida@hsm.min-saude.pt.|Dermatology Research Unit, Medicine Faculty, Lisboa University, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. soaresdealmeida@hsm.min-saude.pt.
authors.forename: Luís
authors.initials: L
authors.lastname: Soares-Almeida
authors.affiliation: Nefrology Unit, Santa Maria Hospital, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. alicesantana1@sapo.pt.
authors.forename: Alice
authors.initials: A
authors.lastname: Santana
authors.affiliation: Nefrology Unit, Santa Maria Hospital, Avenue Prof. Egas Moniz, Lisboa 1649-028, Portugal. joseoliveiraguerra@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Guerra
keywords: herpes zoster; immunosuppression; infection skin disorders in organ transplant recipients