Background: Refractory herpes zoster in immunocompromised patients, particularly those receiving chemotherapy, poses significant clinical challenges due to limited responsiveness to standard antiviral and analgesic therapies. Traditional Chinese medicine (TCM) has been explored as an adjunctive modality to enhance analgesic efficacy and support lesion resolution.
Case report: A 79-year-old patient with ovarian cancer undergoing chemotherapy developed severe HZ affecting the T10-L2 dermatomes. Despite a six-day course of intravenous penciclovir and oral pregabalin, neuropathic pain intensified (Numerical Rating Scale [NRS]: 7-8/10), accompanied by worsening bullous eruptions. A TCM-based intervention consisting of plum-blossom needle bloodletting followed by flash-fire cupping was subsequently implemented. Pain severity was reduced by approximately 90 % (NRS: 2) within 24 h and fully resolved (NRS: 0) by 48 h post-intervention. Skin lesions exhibited complete epithelialization without evidence of secondary infection. At 21-day follow-up, no recurrence or postherpetic neuralgia was observed.
Conclusion: This case demonstrates the potential benefit of integrating TCM modalities with conventional antiviral regimens in the management of refractory herpes zoster among immunocompromised patients. The combined therapeutic approach may contribute to rapid symptom alleviation, improved dermal recovery, and prevention of long-term complications. Further evaluation through rigorously designed controlled studies is recommended.
Keywords: Bloodletting-cupping; Herpes zoster; Immunocompromised host; Ovarian cancer; Traditional Chinese medicine.
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