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A Systematic Review of Zosteriform Rash in Breast Cancer Patients: An Objective Proof of Flap Reinnervation and a
Nouf Al Saud, Samer Jabbour1, Elio Kechichian2
1Plastic and Reconstructive Surgery and.
Annals of Plastic Surgery
|June 1, 2018
Summary
Zosteriform rash in breast cancer patients can indicate reinnervation after reconstruction. However, it may also signal metastasis, requiring careful diagnosis to differentiate from herpes zoster.
Area of Science:
- Oncology
- Dermatology
- Plastic Surgery
Background:
- Zosteriform rash in cancer patients can indicate breast reconstruction reinnervation.
- This rash can be misdiagnosed as herpes zoster but may indicate metastasis.
Purpose of the Study:
- To elucidate the mechanism of reconstruction flap sensory reinnervation.
- To develop a diagnostic and management algorithm for zosteriform rash in breast cancer patients.
Main Methods:
- Systematic review of published articles in MEDLINE and Cochrane databases.
- Inclusion of articles describing zosteriform rash in patients with a history of breast cancer.
Main Results:
- Four of five breast reconstruction patients with flaps showed rash, proving reinnervation.
- Atypical rashes in four patients led to biopsy confirming cancer metastasis.
- Multidermatomal rash in two patients confirmed disseminated herpes zoster via PCR.
Conclusions:
- Herpes zoster reactivation in breast-reconstructed patients proves skin flap reinnervation.
- Zosteriform rash in cancer patients warrants suspicion for metastasis, distinct from herpes zoster.
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