By Gary M. White, MD
Disseminated herpes zoster (DHZ) is the combination of classic herpes zoster infection but with involvement outside the dermatome. This is usually defined as the presence of 20 or more lesions outside the dermatome.
DHZ usually occurs in the setting of immune suppression, e.g., HIV or steroid administration, but it may not. The mortality rate from disseminated herpes zoster has been estimated to be between 5% and 15%.
The prompt administration of an antiviral agent, e.g., acyclovir, should be given. For immunocompromised patients, intravenous administration is preferred. For the immunocompetent patient with a milder case, oral administration can be considered with close monitoring.
There is a diffuse herpes zoster vaccine-type. These patients typically are immune suppressed when they get the Zostavax but they may not be [Am J Infect Control. 2011 Apr;39(3):247-9].
Antiviral prophylaxis is recommended for 6 months following solid organ transplantation and for 1 year following hematopoietic stem cell transplantation to prevent herpes zoster infection.
Dermatol. Argent., 2015, 21 (1): 59-62