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September 1992

The Clinical Spectrum From Classic Varicella Zoster to Zoster Sine Herpete: The Missing Link

Author Affiliations

Department of Dermatology and Cutaneous Surgery University of Miami School of Medicine PO Box 016250 (R-250) Miami, FL 33101

Arch Dermatol. 1992;128(9):1278-1279. doi:10.1001/archderm.1992.01680190138027

To the Editor.—  Varicella zoster infections have a wide range of clinical presentations. All of us are aware of the classic dermatomal presentation.1 At the opposite pole is the entity zoster sine herpete in which patients have acute segmental neuralgia without a cutaneous eruption.2 Along this spectrum there exists a variety of aborted cases where the clinical manifestations are atypical.In classic cases, varicella zoster infection is recognized clinically. Tzanck smears, viral cultures, and immunofluorescent staining3 are other methods that augment our diagnostic skills. In the instance of zoster sine herpete, rising antibody titers serve as a marker for active viral infection.2We have previously reported the use of the polymerase chain reaction (PCR) to diagnose occult or atypical herpes simplex infection.4 We report a case of clinically atypical varicella zoster where PCR allowed us to accurately diagnose the infection.

Report of a Case.—  A

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