Chronic Herpes Zoster Duplex Bilateralis

in Acta Dermato Venereologica (2012)

Although varicella zoster virus latency has been demonstrated in several sensory ganglia, herpes zoster usually effects only one single, either left or right, dermatome in half of the body. In ... [more ▼]

Although varicella zoster virus latency has been demonstrated in several sensory ganglia, herpes zoster usually effects only one single, either left or right, dermatome in half of the body. In immunocompromised patients, more than one contiguous unilateral dermatome may be involved. Bilateral non-contiguous herpes zoster, also termed herpes zoster duplex, is rarely reported. Chronic varicella zoster viurs skin infection is another rare entity encountered in HIV-infected and immunocompromised patients, often associated with aciclovir resistance. We describe here a patient with chronic lymphocytic leukaemia, who presented simultaneously non-contiguous bilateral and chronic herpes zoster lasting fore more than 2 months, with resistance to aciclovir. To our knowledge, this is the first report of chronic herpes zoster duplex bilateralis. Physicians should be aware of and recognize the atypical manifestations of varicella zoster virus. [less ▲]

Herpes zoster in patients treated with biologicals

in Karger (2012)

Background : The incidence and severity of herpes zoster (HZ) appear increased in patients receiving tumor necrosis factor-alpha antagonists. Objective : To study the incidence and clinical features of HZ ... [more ▼]

Background : The incidence and severity of herpes zoster (HZ) appear increased in patients receiving tumor necrosis factor-alpha antagonists. Objective : To study the incidence and clinical features of HZ in 1,220 patients (4.206 patient-years) receiving either adalimumab, etanercept, infliximumab, rituximab or ustekinumab. Results: Twenty-two HZ cases were identified (1.26% of total cohort; adalimumab: 11/1,546 patient-years, incidence rate (IR) 7.1; etanercept: 4/789 patient-years, IR5.1; rituximab: 1/168 patient-years, IR 5.2; ustekinumab: 2/37 patient-years, IR53.5; infliximab: 4/1.666 patient-years, IR 2.4). The time to event varied widely (1.5-108 months). Extensive HZ was reported in 45 and 32% of the cases, respectively. Persistent postzoster neuralgia (PHN;>6months) was observed in 5/20 patients. Conclusions: The Hz incidence was 2.1-fold higher among patients over 60 years, compared with a reference population, although not statistically significant. Severe, multidermatomal HZ and persistent PHN were common. [less ▲]