Simultaneous Involvement of Two Dermatomes

Two weeks earlier, this 66-year-old man had been hospitalized because of leftsided chest pain. However, cardiac evaluation revealed no abnormalities.

The rash developed after the patient had been discharged from the hospital. Painful, vesicular lesions on erythematous bases simultaneously involved the left T4 and T10 dermatomes.

Typically, a single dermatome is affected. Herpes zoster that involves 2 clearly separate dermatomes is very rare.

Treatment with acyclovir, 800 mg qid, resolved both rash and pain within a week.