Mazur M H, Dolin R
Am J Med. 1978 Nov;65(5):738-44. doi: 10.1016/0002-9343(78)90791-x.
One hundred and seven cases of herpes zoster in a hospitalized population with a variety of illnesses during a 20 year period were reviewed. Zoster occurred throughout the year, without seasonal predominance, and was most frequent in lymphoproliferative malignancy. In the majority, lesions were confined to the skin in one or more adjacent dermatomes (localized zoster) and were most frequent in the thoracic region. In 15 per cent of the cases, cutaneous dissemination of the lesions developed; this occurred four to 11 days after the onset of dermatomal lesions, and in one-third of these there was central nervous system involvement. Dissemination of zoster, however, directly resulted in only one death. Predisposing factors for zoster included local irradiation and, occasionally, surgery in subsequently involved areas. There were trends for more frequent splenectomies in patients with Hodgkin's disease in whom zoster subsequently developed, and for more frequent corticosteroid therapy in patiens with disseminated zoster. Advanced stage of Hodgkin's disease, in itself, was not associated with development of zoster, and the onset of zoster did not herald a poor prognosis for the underlying disease. Herpes zoster was, thus, largely a source of increased morbidity rather than mortality in the population studied, and multiple factors appeared to predispose to the development of zoster in this group of patients.
对20年间住院的患有各种疾病的107例带状疱疹患者进行了回顾性研究。带状疱疹全年均有发生，无季节性优势，在淋巴增殖性恶性肿瘤患者中最为常见。大多数患者的皮损局限于一个或多个相邻皮节的皮肤（局限性带状疱疹），且以胸部区域最为常见。15%的病例出现皮损的皮肤播散；这发生在皮节皮损出现后的4至11天，其中三分之一的患者有中枢神经系统受累。然而，带状疱疹的播散仅直接导致1例死亡。带状疱疹的诱发因素包括局部放疗，以及偶尔在随后受累区域进行的手术。在随后发生带状疱疹的霍奇金病患者中，脾切除术更为频繁，而在播散性带状疱疹患者中，皮质类固醇治疗更为频繁。霍奇金病的晚期本身与带状疱疹的发生无关，带状疱疹的发生也并不预示基础疾病的预后不良。因此，在本研究人群中，带状疱疹在很大程度上是发病率增加的一个来源，而非死亡率增加的来源，多种因素似乎易导致该组患者发生带状疱疹。
