title: Herpes zoster and radiation therapy: what radiation oncologists need to know about diagnosing, preventing, and treating herpes zoster.
abstract: Herpes zoster, a viral disease that is characterized by a painful and blistering eruption in the skin, represents reactivation of latent varicella zoster (chickenpox) virus infection. In high-risk groups such as elderly or immunocompromised patients, the incidence of zoster can be as high as 50%. Radiation oncologists are likely to see zoster because cancer, and cancer therapy, can adversely affect immune function. A few reports suggest that radiation therapy is a risk factor for zoster, and that the skin eruption is often in or near the radiation treatment field. The diagnosis is typically made through clinical history and exam, but several tests are available to confirm the diagnosis and differentiate it from other infections or dermatitis. Effective management consists of prompt antiviral medication, acute pain control, appropriate precautions to limit transmission, and referral to specialists in certain cases. Despite appropriate therapy, up to 18% of patients can develop persistent postherpetic neuralgia, defined as pain more than 4 months after resolution of the rash. Several classes of pain medication are available to treat acute or long-term pain. Vaccination against zoster is recommended for patients aged 60 years or older, as it can reduce the incidence and severity of zoster.
authors.affiliation: Department of Radiation Oncology, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Meghan W
authors.initials: MW
authors.lastname: Macomber
authors.affiliation: Department of Infectious Diseases, University of Chicago, Chicago, Illinois.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Mullane
authors.affiliation: Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois. Electronic address: sliauw@radonc.uchicago.edu.
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Liauw
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D006562:Herpes Zoster / Q000175:diagnosis* / Q000517:prevention & control / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents