Abstract：
BACKGROUND: Reactivation of the varicella zoster virus (VZV) results in herpes zoster (HZ), which is a painful unilateral rash with a typical dermatomal distribution. HZ may be followed by postherpetic neuralgia (PHN), vasculopathy, myelopathy, retinal necrosis, and cerebellitis. Vasculopathy can cause ischemic stroke, aneurysms, arterial dissection, transient ischemic attack, and rarely, peripheral arterial disease (PAD). The possible mechanism is that the VZV travels to the arteries through the sensory ganglia, leading to inflammation and pathological vascular remodeling, which result in vasculopathy.
METHODS: Here, we describe a rare case of femoral artery occlusion induced vasculopathy 5 years after HZ. A 65-year-old woman visited our pain clinic with persistent pain following HZ that occurred 3 months earlier. She had several rash scars on the right thigh along with a continuous throbbing, shooting, and sharp pain. The patient was diagnosed with PHN and prescribed with medications that relieved the leg pain. The symptoms remained stationary for almost 5 years. She presented again with complaints of a paroxysmal tingling sensation in the right thigh and claudication due to increased pain, which had begun 6 months prior. She reported leg pain after walking for 10 minutes. Lumbar spine magnetic resonance imaging (MRI) revealed foraminal stenosis at the level of right L2, with no abnormality below L2. Subsequently, the patient was evaluated for vascular diseases. Lower extremity ultrasonography and computed tomography (CT) angiography revealed stenosis and thrombotic occlusions in the right superficial femoral and tibial arteries as well as the left middle femoral and tibial arteries. Surgical revascularization via percutaneous angioplasty was performed bilaterally. The leg pain was relieved after the procedure and the claudication improved.
CONCLUSIONS: Peripheral artery occlusion is a rare phenomenon following HZ. In cases involving changes in HZ symptoms, further evaluation is required for potential vasculopathy.
METHODS: Here, we describe a rare case of femoral artery occlusion induced vasculopathy 5 years after HZ. A 65-year-old woman visited our pain clinic with persistent pain following HZ that occurred 3 months earlier. She had several rash scars on the right thigh along with a continuous throbbing, shooting, and sharp pain. The patient was diagnosed with PHN and prescribed with medications that relieved the leg pain. The symptoms remained stationary for almost 5 years. She presented again with complaints of a paroxysmal tingling sensation in the right thigh and claudication due to increased pain, which had begun 6 months prior. She reported leg pain after walking for 10 minutes. Lumbar spine magnetic resonance imaging (MRI) revealed foraminal stenosis at the level of right L2, with no abnormality below L2. Subsequently, the patient was evaluated for vascular diseases. Lower extremity ultrasonography and computed tomography (CT) angiography revealed stenosis and thrombotic occlusions in the right superficial femoral and tibial arteries as well as the left middle femoral and tibial arteries. Surgical revascularization via percutaneous angioplasty was performed bilaterally. The leg pain was relieved after the procedure and the claudication improved.
CONCLUSIONS: Peripheral artery occlusion is a rare phenomenon following HZ. In cases involving changes in HZ symptoms, further evaluation is required for potential vasculopathy.
摘要：
背景：水痘带状疱疹病毒（VZV）的再激活导致带状疱疹（HZ），这是一种疼痛的单侧皮疹，具有典型的皮肤分布。HZ后可能会出现带状疱疹后遗神经痛（PHN），血管病变,脊髓病,视网膜坏死,和小脑炎.血管病变可引起缺血性卒中,动脉瘤,动脉夹层,短暂性脑缺血发作,很少，外周动脉疾病（PAD）。可能的机制是VZV通过感觉神经节传播到动脉，导致炎症和病理性血管重塑，导致血管病变.
方法：这里，我们描述了HZ后5年的罕见股动脉闭塞引起的血管病变。一名65岁的妇女在3个月前发生的HZ后持续疼痛到我们的疼痛诊所就诊。她的右大腿上有几处皮疹疤痕，并持续跳动，射击,和剧烈的疼痛。患者被诊断为PHN，并服用了缓解腿部疼痛的药物。症状持续了近5年。她再次抱怨右大腿阵发性刺痛感和由于疼痛加剧而导致的跛行，这是在6个月前开始的。她报告步行10分钟后腿部疼痛。腰椎磁共振成像（MRI）显示右侧L2水平椎间孔狭窄，L2以下无异常。随后，对患者的血管疾病进行了评估。下肢超声和计算机断层扫描（CT）血管造影显示右股浅动脉和胫骨动脉以及左股中动脉和胫骨动脉狭窄和血栓闭塞。双侧通过经皮血管成形术进行手术血运重建。术后腿部疼痛缓解，跛行好转。
结论：周围动脉闭塞是HZ后的一种罕见现象。在涉及HZ症状变化的病例中，潜在的血管病变需要进一步评估.
方法：这里，我们描述了HZ后5年的罕见股动脉闭塞引起的血管病变。一名65岁的妇女在3个月前发生的HZ后持续疼痛到我们的疼痛诊所就诊。她的右大腿上有几处皮疹疤痕，并持续跳动，射击,和剧烈的疼痛。患者被诊断为PHN，并服用了缓解腿部疼痛的药物。症状持续了近5年。她再次抱怨右大腿阵发性刺痛感和由于疼痛加剧而导致的跛行，这是在6个月前开始的。她报告步行10分钟后腿部疼痛。腰椎磁共振成像（MRI）显示右侧L2水平椎间孔狭窄，L2以下无异常。随后，对患者的血管疾病进行了评估。下肢超声和计算机断层扫描（CT）血管造影显示右股浅动脉和胫骨动脉以及左股中动脉和胫骨动脉狭窄和血栓闭塞。双侧通过经皮血管成形术进行手术血运重建。术后腿部疼痛缓解，跛行好转。
结论：周围动脉闭塞是HZ后的一种罕见现象。在涉及HZ症状变化的病例中，潜在的血管病变需要进一步评估.
