The significance of herpes zoster is still a matter for speculation. While technically a disease of the skin, the condition is one that has always been of interest to the neurologist and to the general practitioner. Originally regarded as occurring along the distribution of peripheral nerves, it has been recognized, since the epoch-marking discoveries of Henry Head, as having a segmental distribution. Certain aspects of the disease, particularly its relationship to syphilis, have recently been discussed by Brown and Dujardin.1 These observers noted that herpes zoster was distinctly more prevalent among a group of soldiers under observation for syphilis than it was among an unselected group of patients from the civilian population of the district. Among the syphilitics, zoster occurred in a proportion of four cases per thousand, while among the general population the disease occurred only in the proportion of one case per thousand. It was noted, too, that in the syphilitics the herpes had a predilection for the lumbar and sacral ganglions corresponding to the well known observation that spinal syphilis is more likely to attack the lower segments. In connection with these cases of zoster, the authors studied the changes in the spinal fluid and found that there was frequently a lymphocytosis occasionally accompanied by an increase in globulin, and in the case of the syphilitics sometimes accompanied by a positive Wassermann reaction. The authors assume that zoster is an infectious process, and that syphilis acts simply by producing local conditions which predispose the ganglions of the spinal cord to infection with the agent producing the disease.
The Relationship Between Herpes Zoster, Syphilis and Chickenpox. JAMA. 2019;322(17):1722. doi:10.1001/jama.2018.15583
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