In the "normal" patient, herpes zoster can be a devastating event, subjecting some patients to months of debilitating neuritic pain. However, among immunosuppressed patients, especially those with lymphoma, herpes zoster is not only dreaded for its local effects, but also for its potentially fatal visceral dissemination. Recently, vidarabine (ara-A) has been shown to reduce the pain of localized herpes zoster and shorten its course.1 Although certain patients with disseminated zoster seem to respond dramatically to vidarabine, this is not always the case.2 With the release of vidarabine, antiviral chemotherapy is now available through hospital pharmacies across the country, and issues of viral diagnosis and prognosis are no longer academic. Furthermore, initial studies involving interferon3 and a new compound, acyclovir (acycloguanosine),4.5 are also encouraging, and thus antiviral chemotherapy will become even more substantial in the next few years.
Elsewhere in this issue, Mazur et al (p 1341)