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Melatonin has been shown to play a fundamental part in neuroimmunomodulation. Besides regulating the circadian rhythm it works as a natural antioxidant with immune stimulatory and anti-cancer properties. Melatonin is a regulator of haemopoiesis and modifies various cells and cytokines of the immune system. Also, melatonin elicits oncostatic properties in a variety of different tumour cell lines. A number of studies have documented that when given in combination with chemo-therapy to patients with disseminated disease, melatonin increases the overall one-year survival and reduces toxic side effects.

We analysed 19 episodes of herpes zoster in 16 patients, who received cytotoxic drugs or cyclosporin for immuno-inflammatory disease. Reactivation of varicella-zoster virus was not associated with increased activity of the rheumatic disease nor with increased intensity of immunosuppressive therapy. Six of the patients who had received the largest cumulative doses of cytotoxic drugs had fever and/or vesicles outside the primarily affected dermatome. Two of these patients developed post-herpetic neuralgia. Although not encountered in this material, immunocompromised patients may develop severe complications of herpes zoster, and therefore prompt treatment with acyclovir is recommended in all cases. It is suggested that oral acyclovir therapy is sufficient in uncomplicated cases but this question has not been elucidated in controlled studies.