Herpes Zoster of the Sacral Region without Motor Dysfunction in a 55-year-Old Female: A Case Report and Literature Review.

Abstract

Herpes zoster infection, commonly known as shingles, typically involves the thoracic and lumbar dermatomes. Sacral involvement is rare, occurring in only 4-8% of cases. This report presents a 55-year-old female with herpes zoster affecting the S1 dermatome, manifesting as burning pain and clustered vesicles on her right leg, without motor dysfunction or urinary symptoms. A clinical diagnosis was made based on a characteristic unilateral S1 dermatomal vesicular eruption. Despite the rarity of sacral herpes zoster without motor involvement, the patient responded well to antiviral treatment and neuropathic pain management, with no complications noted in the long-term follow-up. This case highlights the necessity for clinicians to consider sacral herpes zoster in patients with radicular pain to prevent misdiagnosis.