Histologic Changes in Sensory Nerves of the Skin in Herpes Zoster

THE MASTERLY postmortem studies of Head and Campbell,¹nearly half a century ago, left little doubt that herpes zoster is associated with a severe inflammatory reaction in the sensory ganglion which supplies the sensory nerves to the area of the skin involved by the eruption. Subsequent work has supported these observations. However, Wohlwill²in 1924 showed that occasionally the inflammatory reaction might be in some other portion of the sensory tract than the ganglion. Death of a ganglion cell is followed by degeneration of its peripheral axon. Using the Marchi method of demonstrating myelin degeneration, Head and Campbell, as well as Wohlwill, found evidence of degeneration of peripheral sensory nerve fibers in the sensory nerve trunks ten to twelve days after onset of herpes zoster. In one or two instances, some degeneration was reported by them to have taken place in the nerves of the skin, but