Although the varicella-zoster virus
infections are usually benign
skin diseases, they can have serious systemic manifestations and complications. This article reviews the current concepts concerning the anatomy and physiology of the virus and the epidemiology, pathogenesis, pathology, immunology, and laboratory diagnosis of these
infections. The information gained in these areas has improved our knowledge of the disease, permitted the detection of susceptible patients, allowed the earlier use of new
antiviral treatment, and provided a background for the use of active and passive immunization. The clinical features and consequences of both
varicella and
herpes zoster are described. The prevention and treatment are underscored, especially with regard to the newer systemic
antiviral therapy.
Herpes zoster ophthalmicus is specifically detailed because of its frequency and because of serious ocular and systemic implications for both the dermatologist and the ophthalmologist. The nerve innervation of the eye and ocular adnexa as it pertains to
herpes zoster ophthalmicus is outlined, and a description is given of the multiple ocular complications for the dermatologist. Data on the role of
antiviral agents and of topical and systemic
corticosteroids in
herpes zoster ophthalmicus are presented.
Postherpetic neuralgia, probably the most difficult management problem of
herpes zoster ophthalmicus, is addressed from a descriptive, preventive, and treatment view.