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Herpes Zoster and Neoplastic Disease

Arthur R. Rhodes, MD, MPH
JAMA. 1976;236(19):2174-2175. doi:10.1001/jama.1976.03270200014015.
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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-Simpson1 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


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