Peripheral vascular spasm as a prodrome of herpes zoster.

SEVERE vascular spasm involving the major arteries of an extremity may occur as a result of embolism, inflammation, or local irritation of larger nerve trunks. Recently we were consulted by a patient with severe arterial spasm of one leg. There was no obvious cause for this spasm, and response to conservative therapy was good. Three days after the onset of symptoms, typical lesions of herpes zoster appeared on the affected leg. Review of the literature did not disclose a similar case. CASE REPORT Mrs. B. L., a 46-year-old white woman, appeared on September 20, 1955, with a complaint of severe pain in the left thigh and leg brought on by exertion. Pain in the leg was extreme, and movement was barely tolerable. Circulation in the right leg was undisturbed. There was no previous history of cardiac or vascular disease and no history of direct trauma. On physical examination the left leg was pale, and mottling was beginning to occur below the knee. The leg and foot were cold to touch. The dorsalis pedis and posterior tibial pulses could not be felt, but the left femoral pulse was barely perceptible.