Herpes zoster following intra-articular corticosteroid injection

Neil F. Fernandes, Rajit Malliah, Todd P. Stitik, Paul Rozdeba, W. Clark Lambert, Robert A. Schwartz

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Localized herpes zoster following intra-articular corticosteroid injection is remarkable. We describe an 80-year-old woman with severe osteoarthritis that received an intra-articular injection of 80 mg methyl-prednisolone in her knee, followed 1 day later by the appearance of linear unilateral vesicles and bullae on her leg in a dermatomal distribution adjacent to the injection site. The roofs of several blisters showed classic viral cytopathic effects for herpes including keratinocytes with multinucleation and margination of chromatin. Varicella zoster virus immunostaining revealed positive staining in the keratinocytes. One plausible explanation is herpes zoster virus reactivation secondary to localized immunosuppression from corticosteroid injection.

Original languageEnglish
Pages (from-to)28-30
Number of pages3
JournalActa Dermatovenerologica Alpina, Panonica et Adriatica
Issue number1
StatePublished - Mar 2009
Externally publishedYes


  • Corticosteroids
  • Herpes zoster
  • Varicella zoster


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