A case of herpes zoster in immune-competent and well-nourished 10-year-old girl.

Introduction: Herpes zoster in childhood is clinical entity which results from reactivation of latent varicella- zoster virus, typically following primary infection in early life. We report a case of HZ in an otherwise healthy child with no documented history of varicella infection or vaccination. Case Presentation: A school-aged female presented with a 7-day history of painful, unilateral vesicular rash localized to the T9 dermatome. A suspected diagnosis was made clinically based on the characteristic dermatomal distribution and morphology of lesions. The lesions demonstrated a dermatomal distribution and did not cross the midline. Although laboratory methods such as Tzanck smear and polymerase chain reaction (PCR) can aid in confirmation, the classical presentation and limited resources made further molecular testing unnecessary. Differential diagnoses, including herpes simplex virus (HSV), were considered but deemed less likely due to the strict dermatomal pattern and absence of recurrent mucocutaneous lesions. The patient was treated with oral acyclovir initiated early in the course of illness, followed by rapid clinical improvement and an uncomplicated recovery. Discussion: This case highlights that HZ can occur in immunocompetent children without a known history of varicella or vaccination, likely due to unrecognized primary infection or early-life exposure. It also emphasizes the importance of clinical diagnosis, the role of early antiviral therapy in improving outcomes, and the generally favorable prognosis of pediatric herpes zoster. Conclusion: Herpes zoster should be considered in the differential diagnosis of children presenting with characteristic dermatomal vesicular eruptions, even in the absence of immunosuppression.