Satellite lesions accompanying herpes zoster: a new prognostic sign for high-risk zoster.
Br J Dermatol
; 172(6): 1530-1534, 2015 Jun.
Article
em En
| MEDLINE
| ID: mdl-25556958
ABSTRACT
BACKGROUND:
The incidence, clinical relevance and pathogenesis of single, isolated, varicella-like skin lesions occurring far beyond the primary herpes zoster (HZ)-affected dermatome remain unclear.OBJECTIVES:
To search prospectively for these satellite lesions in 120 patients with HZ and to correlate their presence with a series of clinical, histological and virological data.METHODS:
Relevant clinical data were recorded from 109 patients with proven HZ using immunohistochemistry on Tzanck smears. Furthermore, skin biopsies and blood samples were obtained from a subgroup of patients presenting with primary HZ with and without satellite lesions for histology, immunohistology, serology and real-time polymerase chain reaction.RESULTS:
This study identified satellite lesions in 21·1% of the patients with HZ. Their presence conveyed a statistically significant relative risk (RR) for severe (RR 3·27, P < 0·001), multidermatomal (RR 10·6, P < 0·001) and multistage HZ (RR 3·30, P < 0·001); systemic signs (RR 2·08, P = 0·0031); immunosuppression (RR 2·38, P = 0·0014) and hospitalization (RR 2·94, P < 0·001). Varicella zoster virus (VZV) viraemia was higher (mean 4075 copies mL(-1) ) in patients with HZ with satellite lesions than in those without (mean 1466 copies mL(-1) ). In contrast to HZ lesions, satellite lesions often presented positive VZV immunostaining in endothelial cells, suggesting a similar pathogenesis to varicella. A limitation of this study is the centre-linked overrepresentation of immunocompromised patients.CONCLUSIONS:
Total-body examination searching for satellite lesions is a rapid, simple and reliable tool for identifying patients with high-risk HZ.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Herpes Zoster
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Br J Dermatol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Bélgica