A study on clinical characteristics of herpes zoster in a tertiary care center

Authors

  • Rachana R. Department of Pharmacology, MS Ramaiah Medical College, Bangalore-54, Karnataka, India
  • Shivaswamy K. N. Department of Dermatology, MS Ramaiah Medical College, Bangalore-54, Karnataka, India
  • Anuradha H. V. Department of Pharmacology, MS Ramaiah Medical College, Bangalore-54, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20170081

Keywords:

Herpes zoster, Dermatomal, Uncomplicated

Abstract

Background: Herpes zoster (HZ), also known as shingles, derived from the Latin word Cingulum, for “girdle”. This is because a common presentation of HZ involves a unilateral rash that can wrap around the waist or torso like a girdle. HZ results due to reactivation of an earlier latent infection with the varicella zoster virus (VZV) in dorsal root ganglia. It occurs at all age groups, common over 60 years of age. It is estimated that in non-immune populations, approximately 15 cases per 1000 people occur per year. The objective of the study was to study the clinical characteristics in patients with uncomplicated herpes zoster.

Methods: A total of 72 patients attending dermatology OPD at Ramaiah medical college between June 2013 to September 2014 were recruited after obtaining informed consent. A detailed history regarding onset of rash, pain, progression, duration and distribution of the lesions were recorded. Demographic information including age, sex, and any other co morbidities noted. Tzanck smear and serology for HIV was done where-ever necessary.

Results: Of the 72 patients, females outnumbered males [M=35(48.61%), F=37 (51.39%)] with male to female ratio of 0.9 to 1. The mean age of presentation was 58±18 years. Majority of the patients (54%) were in the age group of 51 to 70 years followed by 31-50 years (25%). Least number of cases (9%) was in the age group of 21 to 30 years. Of the 72 subjects, thoracic involvement was noted in 30.6%, followed by lumbar (22%), and trigeminal (16%). Cervical (4%) and sacral (2%) involvement was the least.

Conclusions: Herpes zoster commonly occurs in old age and the presenting symptom being pain and burning sensation. Thoracic dermatome is the commonest site. Immunocompromised states like diabetes, malignancy and HIV can increase the risk of developing herpes zoster.

Author Biography

Shivaswamy K. N., Department of Dermatology, MS Ramaiah Medical College, Bangalore-54, Karnataka, India

Associate professor

dept of Dermatology

References

Roxas M. Herpes Zoster and Postherpetic Neuralgia: Diagnosis and Therapeutic. Altern Med Rev. 2006;11(2):102-13.

Wood MJ. History of varicella zoster virus. Herpes. 2000;7:60-5.

Weinberg JM. Herpes Zoster: Epidemiology, natural history and common complications. J Am Acad Dermatol. 2007;57:130-5.

Arora A, Mendoza, Brantley J, Yates B, Dix L, Tyring S. Double-Blind Study Comparing 2 Dosages of Valacyclovir Hydrochloride for the Treatment of Uncomplicated Herpes Zoster in Immunocompromised Patients 18 Years of Age and Older. J Infect Dis. 2008;197(9):1289-95.

Schmader KE. Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Clin J Pain. 2002;18:350-4.

Degreef H. Famciclovir, a new oral antiherpes drug: results of the first controlled clinical study demonstrating its efficacy and safety in the treatment of uncomplicated herpes zoster in immunocompetent patients. Int J Antimicrob Agents. 1994;4:241-6.

Shafran SD, Tyring SK, Ashton R, Decroix J, Forszpaniak C, Wade A, et al. Once, twice, or three times daily famciclovir compared with aciclovir for the oral treatment of herpes zoster in immunocompetent adults: a randomized, multicenter, double-blind clinical trial. J Clin Virol. 2004;29(4):248-53.

Arvin A. Aging, immunity, and the varicella–zoster virus. N Engl J Med. 2005;352:2266-7.

Brown GR. Herpes zoster: correlation of age, sex, distribution, neuralgia, and associated disorders. South Med J. 1976;69:576-8.

Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007;82:1341–9.

Sehgal VN, Rege VL, Kharangate VN, Reys M. The natural history of herpes zoster. Indian J Dermatol Venereol Leprol. 1976;42(2):86-9.

Dubey AK, Jaisankar TJ, Thappa DM. Clinical and morphological characteristics of herpes zoster in south India. Indian J Dermatol. 2005;50(4):203-7.

Tyring SK, Beutner KR, Tucker BA, Anderson WC, Crooks RJ. Antiviral therapy for herpes zoster: randomized, controlled clinical trial of valacyclovir and famciclovir therapy in immunocompetent patients 50 years and older. Arch Fam Med. 2000;9(9):863-9.

Downloads

Published

2017-02-23

Issue

Section

Original Research Articles