Herpes zoster infection after topical steroid use in the setting of tumid lupus erythematosus

CLE: cutaneous lupus erythematosus HZ: herpes zoster SLE: systemic lupus erythematosus TLE: tumid lupus erythematosus VZV: varicella zoster virus INTRODUCTION Topical corticosteroids are commonly used in the treatment of a wide range of skin manifestations of systemic lupus erythematosus (SLE). Patients with SLE are also known to have an increased risk of herpes zoster (HZ). Here we present a rare case of recurrent HZ induced by topical corticosteroid use for the treatment of tumid lupus in the background of systemic lupus. We also review the literature on topical corticosteroid use and varicella zoster infection. For the literature review, search terms both as keywords and subject headings, included topical corticosteroids, topical steroids, corticosteroids AND systemic lupus erythematosus, lupus, cutaneous lupus AND herpes zoster, herpes virus, varicella zoster, shingles. HZ is a rare complication of topical corticosteroid use. Providers should use caution in the treatment of cutaneous lupus erythematosus (CLE) with topical steroids, as these patients are at an increased risk for HZ infection.