Varicella-zoster

Gilden, Don; Nagel, Maria A.; Cohrs, Randall J.

doi:10.1016/b978-0-444-53488-0.00012-2

Cited by 47 publications

(38 citation statements)

References 173 publications

(185 reference statements)

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“…Less commonly, disseminated herpes zoster can present as multiple, widely distributed, individual vesicles—with or without—associated dermatomal skin involvement. In addition to a positive viral culture for varicella-zoster virus, bacterial culture can concurrently be positive for S. aureus when the vesicular, ulcerated or crusted lesions become colonized or secondarily infected by the bacterial organism [ 2 , 7 – 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Zosteriform impetigo is favored to represent Wolf’s postherpetic isotopic response in a cutaneous immunocompromised district [ 3 , 8 , 11 , 12 ]. The absence of a definitive history of preceding varicella-zoster virus infection in 75 percent of the individuals (3 of the 4 patients) may reflect a prior subclinical varicella-zoster virus infection, such as an episode of asymptomatic zoster sine herpete [ 7 , 8 ]. Alternatively, and often similar in presentation with a dermatomal distribution, is the possibility of a Blascho linear arrangement due to skin mosaicism [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Zosteriform impetigo: Wolf’s isotopic response in a cutaneous immunocompromised district

Cohen

2015

Dermatol Pract Concept

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Background:Impetigo can result from Staphylococcus aureus (S. aureus). Wolf’s isotopic response is the occurrence of a new cutaneous disorder at the site of a previously healed disease. A cutaneous immunocompromised district is an area of skin that is more vulnerable than the rest of the individual’s body.Purpose:To describe a man with impetigo localized to a unilateral dermatome and review the clinical features of other patients with zosteriform Staphylococcus aureus cutaneous infection.Methods:PubMed was used to search the following terms, separately and in combination: cutaneous, dermatome, dermatomal, district, herpes, immunocompromised, impetigo, infection, isotopic, response, skin, staphylococcal, Staphylococcus aureus, Wolf, zoster, zosteriform. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated.Results:Crusted, eroded and intact, erythematous papules and nodules acutely presented localized to the mandibular branch of the left trigeminal nerve on the face of a 66-year-old man; he did not recall a prior episode of varicella-zoster virus infection in that area. A bacterial culture isolated methicillin-susceptible S. aureus. Viral cultures and direct fluorescent absorption studies were negative for herpes simplex and herpes zoster virus. All of the lesions resolved after oral treatment with cefdinir. Impetigo and/or furunculosis in a zosteriform distribution have also been described in 3 additional patients. The bacterial culture showed either methicillin-susceptible or methicillin-resistant S. aureus; the skin infection resolved after treatment with oral antibiotics; however one man experienced 2 recurrences in the same area.Conclusions:Zosteriform cutaneous staphylococcal impetigo may be an example of Wolf’s isotopic response in a cutaneous immunocompromised district

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Zosteriform impetigo: Wolf’s isotopic response in a cutaneous immunocompromised district

Cohen

2015

Dermatol Pract Concept

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“…Varicella-zoster virus (VZV) is a member of the alpha-herpes virus subfamily that causes chickenpox early in life and then remains latent in neurons of sensory ganglia for the lifetime of the individual [ 1 ]. In persons with immune deficiencies and in older individuals with a waning immune system, VZV can reactivate causing herpes zoster (HZ), also known as shingles [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…HZ is quite frequent, and approximately one third of the population may experience zoster once in their lifetime [ 3 ]. Adults over the age of 50 are particularly susceptible to HZ [ 1 ], implicating a stronger role of acquired factors compared to genetic influences [ 4 ]. One potential consequence of HZ is the development of postherpetic neuralgia (PHN), defined as pain that lasts for greater than 3 months and which originates in the same area as the HZ rash.…”

Section: Introductionmentioning

confidence: 99%

Anti-cytokine autoantibodies in postherpetic neuralgia

et al. 2015

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BackgroundThe mechanisms by which varicella zoster virus (VZV) reactivation causes postherpetic neuralgia (PHN), a debilitating chronic pain condition, have not been fully elucidated. Based on previous studies identifying a causative role for anti-cytokine autoantibodies in patients with opportunistic infections, we explored this possibility in PHN.MethodsSera from herpes zoster (HZ) patients without and with PHN (N = 115 and 83, respectively) were examined for the presence of autoantibodies against multiple cytokines, and other known autoantigens. In addition, a cohort of patients with complex regional pain syndrome or neuropathic pain was tested for autoantibodies against selected cytokines. Antibody levels against VZV, Epstein Barr virus, and herpes simplex virus-2 were also measured in the HZ and PHN patients. Patient sera with high levels of anti-cytokine autoantibodies were functionally tested for in vitro neutralizing activity.ResultsSix PHN subjects demonstrated markedly elevated levels of single, autoantibodies against interferon-α, interferon-γ, GM-CSF, or interleukin-6. In contrast, the HZ and the pain control group showed low or no autoantibodies, respectively, against these four cytokines. Further analysis revealed that one PHN patient with high levels of anti-interleukin-6 autoantibodies had a markedly depressed antibody level to VZV, potentially reflecting poor T cell immunity against VZV. In vitro functional testing revealed that three of the five anti-cytokine autoantibody positive PHN subjects had neutralizing autoantibodies against interferon-α, GM-CSF or interleukin-6. In contrast, none of the HZ patients without PHN had neutralizing autoantibodies.ConclusionsThese results suggest the possibility that sporadic anti-cytokine autoantibodies in some subjects may cause an autoimmune immunodeficiency syndrome leading to uncontrolled VZV reactivation, nerve damage and subsequent PHN.

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“…VZV primary infection results in the common childhood disease varicella (chickenpox) after which the virus establishes latency in the ganglia of a variety of neurons (Gilden et al, 2014). Reactivation of the virus results in zoster (shingles) and other chronic pain diseases, which can be manifest in various places on the epithelium (Gilden et al, 2014).…”

Section: Alphaherpesvirinaementioning

confidence: 99%