An analytical study on clinical patterns of herpes zoster in this era

Abstract

Background: Herpes zoster is a major health burden in all age groups. It is caused by reactivation of varicella zoster virus from dormant form. The immunity that plays a role in this reactivation is cell mediated immunity. Prodromal features like Fever, pain and itch are common before the onset of zoster rash. The most common complication associated with this disease is post-herpetic neuralgia. Complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Treatment with antiviral drugs within 72 hours of onset of rash onset has been shown to reduce severity and complications associated with zoster and the post-herpetic neuralgia.

Methods: We analysed 120 cases of herpes zoster patients who attended Dermatology OPD, in Chengalpattu Medical College Hospital from January 2018 to December 2018. The study design was descriptive study. A detailed history taking, thorough clinical examination and appropriate relevant investigations were done.

Results: The mean age group of the 120 patients (male-56, female-64) was 35 years. Segmental distribution: Thoracic-60%, cervical-6%, lumbosacral-2%, herpes zoster ophthalmicus-22%, herpes zoster oticus-10%. 34% were diabetic, 2% HIV, 4% following surgery/trauma, 10% on steroid therapy. 13% had history of native treatment. Prodromal symptoms in 34%, post herpetic neuralgia-60%, sepsis in 52%.

Conclusions: Herpes zoster occurs in dermatomes in which the rash of varicella achieves highest intensity. Herpes zoster can affect any age group with a higher incidence in elderly patients and in those with immuno-compromised status, treatment with antivirals within 72 hours of onset of rash has shown a reduction in severity and complications.