A Systematic Review of Zosteriform Rash in Breast Cancer Patients: An Objective Proof of Flap Reinnervation and a Management Algorithm
Abstract
Zosteriform rash in cancer patients provides objective clues to the process of reinnervation of the reconstructed breast. This rash should also raise suspicion for metastasis, which can be confused with herpes zoster. The aims of this study were to explain the reconstruction flap sensory reinnervation mechanism based on the clinical findings and provide a diagnostic and management algorithm of zosteriform rash in breast cancer patients. On November 15, 2017, we conducted a search of published articles in MEDLINE and Cochrane databases. All the articles describing a zosteriform rash in a patient with a history of breast cancer were included in this review. Eleven articles from the literature and 1 case from our practice were selected for inclusion in this systematic review. Five patients had a breast reconstruction with a flap. The flap skin was affected by the rash in 4 of these patients, providing an objective proof of the reinnervation of the reconstructed breast. In 6 patients, the presentation was typical, and the diagnosis of herpes zoster was made without additional diagnostic testing. In 4 cases, the eruption was atypical, and a biopsy was done to confirm the diagnosis of a cancer metastasis. In 2 patients, the rash was ...Continue Reading
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