Retrospective Analysis of 170 Patients Followed up with Herpes Zoster and Postherpetic Neuralgia in Nothern Cyprus

Dua Cebeci; Seide Karasel

doi:10.3889/oamjms.2021.6251

Authors

Dua Cebeci Department of Dermatology and Venerology, Famagusta State Hospital, Famagusta, Cyprus https://orcid.org/0000-0001-5746-9326
Seide Karasel Department of Physical Medicine and Rehabilitation, Famagusta State Hospital, Famagusta, Cyprus

DOI:

https://doi.org/10.3889/oamjms.2021.6251

Keywords:

Herpes zoster, Incidence, Neuralgia, Primary care, Risk factors

Abstract

Herpes zoster is viral infection that occurs with reactivation of the varicella-zoster virus (VZV). It is usually a painful but self-limited dermatomal rash with cutaneous distribution. Although it's usually a painful, self-limiting rash, it can be much more serious; In addition, acute cases often lead to postherpetic neuralgia (PHN) and seriously impair quality of life. It is important to recognize those at risk of developing postherpetic neuralgia, early treatment and prevent complications.

Objectives :Our aim is to determine the clinical features of our herpes zoster diseases and to review the treatments in patients with postherpetic neuralgia.

Methods: A search for HZ and PHN was conducted in a general practice research database, comprising 2 general practices( dermatologist and physatrist) and representing 5600 people. We analyzed a retrospective 170 case series of pediatirc and adults addmited to the dermatology and physical therapy and rehabilitation outpatient clinic between October 2018 and October 2020.

Results: A total of 170 new cases had been diagnosed with HZ in the dermatology and physical therapy and rehabilitation clinics over 2 years . Female to male ratio was 2:1 and the age ranged from 5 years to 88 years. The thoracic dermatomes were the most commonly involved. The risk of developing PHN 1 month after the start of the zoster rash was 21 %. Independent risk indicators for the occurrence of PHN were age [55–74] years.

Conclusion : The risk of developing PHN increases with age and with commorbitity. Preventive strategies such as vaccination should focus on patients with herpes zoster aged >55 years.

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References

Nair PA, Patel BC. Herpes zoster. In: Stat Pearls. Treasure Island, FL: Stat Pearls Publishing; 2020.

Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch Intern Med. 1995;155(15):1605-9. https://doi.org/10.1001/archinte.1995.00430150071008 PMıd:7618983

Gauthier A, Breuer J, Carrington D, Martin M, Remy V. Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect. 2009;137(1):38-47. https://doi.org/10.1017/s0950268808000678 PMıd:18466661

Nalamachu S, Morley-Forster P. Diagnosing and managing postherpetic neuralgia. Drugs Aging. 2012;29(11):863-9. https://doi.org/10.1007/s40266-012-0014-3 PMıd:23038608

Mallick-Searle T, Snodgrass B, Brant JM. Postherpetic neuralgia: Epidemiology, pathophysiology, and pain management pharmacology. J Multidiscip Healthc. 2016;9:447-54. https://doi.org/10.2147/jmdh.s106340 PMıd:27703368

Dubinsky RM, Kabbani H, El-Chami Z, Boutwell C, Ali H, Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: Treatment of postherpetic neuralgia: An evidence-based report of the quality standards subcommittee of the American Academy of Neurology. Neurology. 2004;63(6):959-65. https://doi.org/10.1212/01.wnl.0000140708.62856.72 PMıd:15452284

Argoff CE. Review of current guidelines on the care of postherpetic neuralgia. Postgrad Med. 2011;123(5):134-42. PMıd:21904096

Hope-Simpson RE. Postherpetic neuralgia. J R Coll Gen Pract. 1975;25(157):571-5. PMıd:1195231

Petursson G, Helgason S, Gudmundsson S, Sigurdsson JA. Herpes zoster in children and adolescents. Pediatr Infect Dis J. 1998;17(10):905-8. https://doi.org/10.1097/00006454-199810000-00011 PMıd:9802633

Zak-Prelich M, Borkowski JL, Alexander F, Norval M. The role of solar ultraviolet irradiation in zoster. Epidemiol Infect. 2002;129(3):593-7. https://doi.org/10.1017/s0950268802007793 PMıd:12558343

Oxman MN. Clinical manifestations of herpes zoster. In: Arvin AM, Gershon AA, editors. Varicella-Zoster Virus: Virology and Clinical Management. Cambridge, England: Cambridge University Press; 2000. p. 246-75. https://doi.org/10.1017/cbo9780511601194.015

Benbernou A, Drolet M, Levin MJ, Schmader KE, Oxman MN, Johnson R, et al. Association between prodromal pain and the severity of acute herpes zoster and utilization of health care resources. Eur J Pain. 2011;15(10):1100-6. https://doi.org/10.1016/j.ejpain.2011.04.014 PMıd:21600819

Choo PW, Galil K, Donahue JG, Walker AM, Spiegelman D, Platt R. Risk factors for postherpetic neuralgia. Arch Intern Med. 1997;157(11):1217-24. https://doi.org/10.1001/archinte.1997.00440320117011 PMıd:9183233

Arvin AM. Varicella-zoster virus. Clin Microbiol Rev. 1996;9(3):361-81. PMıd:8809466

El Hayderi L, Nikkels-Tassoudji N, Nikkels AF. Incidence of and risk factors for cutaneous scarring after herpes zoster. Am J Clin Dermatol. 2018;19(6):893-7. https://doi.org/10.1007/s40257-018-0385-2 PMıd:30151702

Johnson RW. Herpes zoster and postherpetic neuralgia. Expert Rev Vaccines. 2010;9 Suppl 3:21-6. https://doi.org/10.1586/erv.10.30 PMıd:20192714

Cohen JI. Clinical practice: Herpes zoster. N Engl J Med. 2013;369(3):255-63. PMıd:23863052

Werner RN, Nikkels AF, Marinović B, Schäfer M, Czarnecka-Operacz M, Agius AM, et al. European consensus-based (S2k) guideline on the management of herpes zoster-guided by the European Dermatology Forum (EDF) in cooperation with the european academy of dermatology and venereology (EADV), Part 2: Treatment. J Eur Acad Dermatol Venereol. 2017;31(1):20-9. https://doi.org/10.1111/jdv.13957 PMıd:27579792

Madkan VK, Arora A, Babb-Tarbox M, Aboutlabeti S, Tyring S. Open-label study ofvalacyclovir 1.5 g twice daily for the treatment of uncomplicatedherpes zoster in immunocompetent patients 18 years of age orolder. J Cutan Med Surg. 2007;11(3):89-98. https://doi.org/10.2310/7750.2007.00016 PMıd:17511925

Alakloby OM, AlJabre SH, Randhawa MA, Alzahrani AJ, AlWunais KM, Bukhari IA. Herpes zoster in eastern Saudi Arabia: Clinical presentation and management. J Drugs Dermatol. 2008;7(5):457-62. PMıd:18505138