Satellite lesions prognostic for high-risk zoster

(HealthDay)—For patients with herpes zoster, satellite lesions are prognostic of high-risk disease, according to a study published online Dec. 30 in the British Journal of Dermatology.

Lara el Hayderi, from the University of Liège in Belgium, and colleagues prospectively searched for single, isolated, varicella-like skin lesions in herpes zoster patients. Relevant clinical data were obtained from 109 patients with proven herpes zoster.

The researchers identified satellite lesions in 21.1 percent of patients. The presence of lesions correlated with increased relative risk (RR) for severe, multidermatome, and multistage herpes zoster (RR, 3.27, 10.6, and 3.30, respectively; all P < 0.0001), and with systemic signs (RR, 2.08; P = 0.0031), immunosuppression (RR, 2.38; P = 0.0014), and hospitalization (RR, 2.94; P < 0.0001). In herpes zoster patients with satellite lesions, varicella zoster virus viremia was higher than in patients without satellite lesions (mean: 4,075 versus 1,466 copies/mL). Satellite lesions often presented positive varicella zoster virus immunostaining in endothelial cells, in contrast to herpes zoster lesions.

"Total body examination searching for satellite lesions is a rapid, simple, and reliable tool for identifying patients with high-risk herpes zoster," the authors write.