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Neurology
Herpes zoster infection in a patient with relapsing-remitting multiple sclerosis treated with diroximel fumarate
  1. John Dempsey1,2,
  2. Alexandra Balshi2 and
  3. Jacob Sloane2
  1. 1SUNY Upstate Medical University Norton College of Medicine, Syracuse, New York, USA
  2. 2Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  1. Correspondence to John Dempsey; dempseyj{at}upstate.edu

Abstract

We present a case of a woman in her 50s with relapsing-remitting multiple sclerosis, treated with diroximel fumarate, who developed an itching, burning vesicular rash following a C3 dermatomal distribution on her left face and neck. She was diagnosed with herpes zoster, treated with valacyclovir and gabapentin, and made a full recovery. Ensuring patients are protected against varicella-zoster virus before starting diroximel fumarate can prevent this painful infection. Thus, we recommend vaccination against the varicella-zoster virus prior to diroximel fumarate initiation be incorporated as the standard of care.

  • Infections
  • Multiple sclerosis

https://doi.org/10.1136/bcr-2024-264081

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    Footnotes

    • Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: JD, AB and JS. The following authors gave final approval of the manuscript: JD, AB and JS. Guarantor: JS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests JS has grant funding from National MS Society and has consulted for Biogen, Genentech, Teva, Banner, Sanofi, and Cellgene.

    • Provenance and peer review Not commissioned; externally peer reviewed.