Abstract
RATIONALE: Hand herpes zoster (HHZ) is a very rare skin disease in clinical practice. Due to the lack of specificity in its early clinical manifestations, HHZ is easily misdiagnosed as hand eczema or other lesions. Herein, we present a case with atypical HHZ. PATIENT CONCERNS: A 25-year-old woman experienced left palm pain accompanied by upper limb stabbing pain, general weakness, and low-grade fever after staying up late. At first, she was diagnosed with peripheral nerve compression and hand eczema, and received relevant symptomatic treatment, but her condition did not improve. Diagnosed with herpes zoster on the hand after skin biopsy, treated with thread fragrant moxibustion (TFM). DIAGNOSES: The HHZ diagnosis was established based on clinical appearance and dermatological findings eventually. INTERVENTIONS: The intervention project was TFM treatment once a day in the acupuncture and moxibustion department, and the whole treatment period lasted for 10 days. OUTCOMES: After 3 more TFM treatments were given, the burning sensation and itching in her palms as well as the pulsatility of the finger blood vessels had significantly reduction, the visual analog scale scores significantly decreased. After 10 treatments, the patient's herpes gradually falls off, revealing pink new skin without any discomfort. LESSONS: Herpes zoster can appear in any part of the human body with different clinical manifestations. Herpes zoster in the hands is very rare in clinical practice, and it is often misdiagnosed as hand eczema or other lesions in the early stages of the disease. The case is not only highlights the challenging diagnosis in the absence of a characteristic rash at the initial stage but also confirmed the definite therapeutic effect of TFM on herpes zoster.