Segmental Zoster Abdominal Paresis without Skin Rash.

An 80-year-old man with a history of dementia presented with a chief complaint of an abdominal mass (Picture 1). He did not complain of any abdominal pain and also had no tenderness. Computed tomography (CT) showed no bowel herniation but a thinning of the transverse abdominal muscle (Picture 2). His wife mentioned that he had a skin rash in the same area two weeks before this visit. Based on this history, he was diagnosed to have segmental zoster abdominal paresis.

Picture 1.

Picture 2.

At the 2-month follow-up, the abdominal deformity had improved (Picture 3) and the muscle thinning on CT had also improved (Picture 4). Although this disease has been shown to demonstrate various clinical symptoms (1), most are usually accompanied by a skin rash. In the latest review, it was reported to normally occur from 1 to 6 weeks after the appearance of a rash (2). Therefore, clinicians may encounter such patients with the absence of a skin rash.

Picture 3.

Picture 4.

The authors state that they have no Conflict of Interest (COI).