Herpes Zoster and Neoplastic Disease

Abstract

To the Editor.— I read the case of a child with vesicular groin rash (235:2238, 1976) and the consultant's reply to the question: Should this child (with possible herpes zoster) be investigated for underlying disease? Assuming the child's rash was herpes zoster, I would like to disagree with Dr Wehrle's reply that approximately 10% of patients with herpes zoster will have underlying problems. Available information indicates that only 1% or less of patients with localized herpes zoster (LHZ) have underlying disease. Hope-Simpson 1 found trauma and sinusitis were associated events in 192 patients with LHZ, but none of this group had underlying malignant disease. Of 100 patients with LHZ studied by Juel-Jensen, 2 none had unsuspected malignant disease, while three patients had preexisting lymphoreticular disease or carcinoma. Burgoon et al studied 206 patients with LHZ (164:265, 1957); one had lymphoblastoma. In Molin's 706 patients with LHZ, 3 six had malignant