Treatment of disseminated herpes zoster in six severely immunocompromised patients. Acyclovir and vidarabine.

We treated 6 patients with disseminated herpes zoster (D-H-Z) and in a severely immunocompromised condition. Three were effectively treated with 15 mg/kg/day of acyclovir. Ten mg/kg/day of vidarabine alone was given to two patients, but without positive effects. In two patients, acyclovir was effective in limiting the progression of the lesions. The skin lesions looked like a "stitch" on vesicles, thereby suggesting that the "stitch like appearance" may be a useful marker to identify the resistance to acyclovir treatment. In one patient, acyclovir was given for 58 days, but with limited effectiveness. When vidarabine was given in addition to acyclovir, the lesions dramatically disappeared. These findings suggest that acyclovir is superior to vidarabine for treating D-H-Z and the combination therapy with acyclovir and vidarabine should be considered for prescription for patients with D-H-Z, if acyclovir alone is not completely effective.