Herpes zoster laryngis with prelaryngeal skin erythema.

A 74-year-old man came to our hospital with complete left vocal cord paralysis and erythema of the prelaryngeal skin. The patient also had mucosal swelling and erosions in the left arytenoid cartilage, aryepiglottic fold, and pyriform sinus. Herpetic vesicles developed over the prelaryngeal erythema 4 days after admission. An increase in the varicella-zoster immunoglobulin G level to 3,294 IU/mL confirmed varicella-zoster virus infection of the larynx and prelaryngeal skin. The patient was treated with acyclovir without marked effect. Nevertheless, in cases of unilateral vocal cord paralysis and erythema of the ipsilateral prelaryngeal skin, we advise that herpes zoster laryngis must be considered and treatment with early intravenous acyclovir started.