Because of its ability to produce two clinically distinct disease entities
(chickenpox and shingles), varicella tester virus (VZV) is an unusual etiol
ogic agent. Although in the past viral exanthems were mostly only of academ
ic interest to the practitioner, the development of antiviral agents and th
e newly approved varicella (OKA) vaccine have increased the clinical signif
icance. Also, with the increasing seroprevalence of HIV infection, more pat
ients will be stricken with tester (at a younger age) and disseminated vari
cella. In this review, the history, incidence, pathogenesis, clinical manif
estations, and treatment options (of VZV infection and postherpetic neuralg
ia) will be discussed.