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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Herpes zoster &#40;HZ&#41; is caused by the reactivation of the latent varicella-zoster virus &#40;VZV&#41; in the dorsal root ganglia&#46; As a result&#44; the most common complication of HZ is postherpetic neuralgia&#46; In rare instances&#44; the virus can involve the ventral horn cells of the spinal nerve&#44; leading to motor complications like an abdominal phantom hernia&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> We describe two such cases that presented to our department&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Case 1&#58; A 72-year-old man presented with complaints of swelling and pain on the right side of the abdomen for 10 days&#46; He had a history of herpes zoster that had occurred a month prior and was treated appropriately with antivirals&#46; On examination&#44; we observed crusted haemorrhagic plaques on the right side of the abdomen&#44; involving T11&#8211;T12 dermatomes&#46; Distension of the right side of the abdomen was also noted &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Tenderness was present on palpation&#46; An ultrasound of the abdomen and pelvis showed no abnormality&#46; A diagnosis of post-herpetic neuralgia with phantom hernia was made&#46; He was reassured that the distension would resolve with time but was also counselled regarding the possible development of gastric complaints&#46; Review after 3 months showed a mild decrease in the distension with complete resolution after 10 months&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Case 2&#58; A 69-year-old man with comorbidities of diabetes and hypertension was referred to our department&#46; He was treated three months&#8217; prior for herpes zoster of the right T10&#8211;T12 dermatomes&#46; On examination&#44; we observed the presence of depigmented atrophic scars on the right side of the abdomen along the T10&#8211;T12 dermatomes&#44; with mild distension of the abdomen &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; There was no tenderness on palpation&#46; Ultrasonography of the abdomen revealed no abnormality and a diagnosis of phantom hernia was confirmed along with the surgery team&#46; He was reassured and taught abdominal strengthening exercises&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">A pseudo hernia is defined as &#8216;bulging of the abdominal wall that is not caused by structural defects&#44; collection of fluid&#44; or a mass but&#44; rather&#44; muscle paralysis&#46;&#8217;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Common causes include diabetic radiculoneuropathy&#44; trauma or ventral root injury&#46; Pseudo hernia due to HZ occurs in 0&#46;17&#37; of the cases and is a rare complication&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> It occurs most commonly in middle-aged to elderly&#44; obese individuals and has been seen to commonly involve the T11 dermatome&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> This muscle paralysis is hypothesised to occur as a result of the direct spread of the virus from the dorsal root ganglia to the ventral horn cells and motor nerve roots&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;3</span></a> The prognosis is generally favourable with full clinical recovery in 55&#8211;78&#37; of cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">5&#44;6</span></a> This entity has been described in very few dermatological journals&#46; Since many cases come for follow up to the dermatology clinic&#44; it is important to keep in mind the risk of developing pseudo-hernias in elderly individuals&#46; Keen observation and detailed history can help in the clinical diagnosis of this condition&#44; thus avoiding unnecessary diagnostic studies and surgical intervention&#46; Watchful waiting is the best therapeutic option for such cases along with abdominal strengthening exercises&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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