Shingles pseudohernia (postherpetic)

Postherpetic abdominal pseudohernia is uncommon

• incidence of segmental motor weakness occurs in approximately 2% of patients with herpes zoster (1)
  • been reported that 0.7% of herpes zoster infections are associated with abdominal wall hernia (2,3)
    
    
• should be be suspected when a patient develops motor dysfunction coincident with or following a herpes zoster eruption
  
  
• presentation may reveal deviation of the umbilicus and central line of the abdomen to the unaffected side suggests abdominal wall muscle paralysis
  
  
• postherpetic abdominal pseudohernia is potentially reversible and does not require surgical intervention
  • most patients with pseudohernia after herpes zoster will recover in one year, without substantial sequelae (4)

Reference:

• 1. Dobrev, H., P. Atanassova, and V. Sirakov. 2008. Postherpetic abdominal-wall pseudohernia. Clin. Exp. Dermatol. 33:677-678.
• Thomas JE, Howard FM Jr. Segmental zoster paresis--a disease profile. Neurology1972;358:459-66.
• Mancuso M, Virgili MP, Pizzanelli C, et al. Abdominal pseudohernia caused by herpes zoster truncal D12 radiculoneuropathy. Arch Neurol2006;358:1327.
• Oliveira PD, dos Santos Filho PV, de Menezes Ettinger JE, et al. Abdominal-wall postherpetic pseudohernia. Hernia 2006; 10:364-6.