Hutchinson’s sign: a clinical clue for the diagnosis of herpes zoster ophthalmicus

Authors

  • Diana Unidade de Saúde Familiar do Mar, ACeS Grande Porto IV – Póvoa de Varzim/Vila do Conde
  • Pedro Peixoto ACeS Grande Porto IV – Póvoa de Varzim/Vila do Conde
  • Sandra Unidade de Saúde Familiar do Mar, ACeS Grande Porto IV – Póvoa de Varzim/Vila do Conde

DOI:

https://doi.org/10.32385/rpmgf.v39i3.13573

Keywords:

Herpes zoster, Herpes zoster ophthalmicus, Hutchinson’s sign

Abstract

Introduction: Herpes zoster results from the reactivation of varicella-zoster virus (VZV) after primary infection (varicella). Herpes zoster ophthalmicus occurs when there is reactivation of VZV involving the ophthalmic branch of the trigeminal nerve and it results in a higher risk of long-term sequelae.

Case report: This case presents a 74-year-old man with herpes zoster ophthalmicus who had a vesicular rash involving the tip of the nose – Hutchinson’s sign. This sign is a strong predictor of ocular complications due to the involvement of the nasociliary nerve.

Comments: This case report highlights the need for a complete physical examination, including urgent ophthalmic evaluation when suspicious of herpes zoster ophthalmicus.

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References

Li JY. Herpes zoster ophthalmicus: acute keratitis. Curr Opin Ophtalmol. 2018;29(4):328-33.

Vrcek I, Choudhury E, Durairaj V. Herpes zoster ophthalmicus: a review for the internist. Am J Med. 2017;130(1):21-6.

Kleinschmidt-DeMasters BK, Gilden DH. Varicella-zoster virus infections of the nervous system: clinical and pathologic correlates. Arch Pathol Lab Med. 2001;125(6):770-80.

Johnson JL, Amzat R, Martin N. Herpes zoster ophthalmicus. Prim Care. 2015;42(3):285-303.

Liesegang TJ. Herpes zoster ophthalmicus natural history, risk factors, clinical presentation, and morbidity. Ophthalmology. 2008;115(2 Suppl):S3-12.

Szent-Ivanyi J, Hassan AS, Teimory M. Herpes zoster ophthalmicus: is the globe involved? BMJ Case Rep. 2014;2014:bcr2014204566.

Zaal MJ, Völker-Dieben HJ, D’Amaro J. Prognostic value of Hutchinson’s sign in acute herpes zoster ophthalmicus. Graefes Arch Clin Exp Ophthalmol. 2003;241(3):187-91.

Ting DS, Ghosh N, Ghosh S. Herpes zoster ophthalmicus. BMJ. 2019;364:k5234.

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Published

2023-07-05

Issue

Vol. 39 No. 3 (2023): Revista Portuguesa de Medicina Geral e Familiar

Section

Case Reports

License

Copyright (c) 2023 Portuguese Journal of Family Medicine and General Practice

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How to Cite

Hutchinson’s sign: a clinical clue for the diagnosis of herpes zoster ophthalmicus. (2023). Portuguese Journal of Family Medicine and General Practice, 39(3), 239-42. https://doi.org/10.32385/rpmgf.v39i3.13573

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