A Clinical Study and Acyclovir Therapy of Herpes Zoster

Lee, H R; Lee, M J; Hahm, J H

Abstract

BACKGROUND: Herpes zoster is an acute localized infection caused by varicella-zoster virus and characterized by unilateral pain and vesicular eruptions along the sensory dermatomes.
OBJECTIVE
The purpoe of this study was to elucidate the clinical features of herpes zoster and estimate the current theeap utic effect of Aeyclovir on herpes zoster. METHOD: We studied 517 cases of herpes zoster by retrospective method comparing annual incidence, age and monthly vacations, predilection site, associated conditions, complication and disease progress according toicylovir treatmentat at the department of dermatology, Ewha Womans University Hospital over 4 years(1990-1993).
RESULTS
1. The average annual incidence during the 4 years was 0.2%, being on the increase recently. There was no significant, mannual, seasonal and monthly variation and the majority of cases occurred mast frequently were the fifth decade. 2. The dermatomal involvement of herpes zoster were most frequently on the thoracic dermatome (54.7%), followed by cervical, ophthalmic branch of trigeminal nerve, lumbar, sacral, maxillary branch of trigeminal nerve and mandibular branch of trigeminal nerve. The frequencies of associ ated conditions in herpcsioster, in descending order, were diabetes mellitus, hypertension, infectious disease, gastritis urgastric ulcer, malignant neoplasm, cardiovascular disease and postoperative condition. 3. The duration of treatment in herpes zoster was 3.8 weeks and significantly shortened in acyclovir-using group(p<0.05). The duration of treatment was significantly prolonged in associated disease (p <0.01). 4. Postherpetic neuralgil was the most common complication(11.2%), followed by ophthalmic complications, varicelliform erptions, secondary bacterial infections, meningoencephalitis, recurrent herpes zoster, keloid fomation, urinary retention, ptosis and hypopigmentation. Postherpetic neu ralgia increased with age and was observed most frequently in the ophthalmic branch of trigerninal nerve.
CONCLUSION
The annwal incidence of herpes zoster shows a tendency to increase recently but there was no significant monthly or seasonal variation. The most common anatomical distribution was on the thoracic dematome. Herpes zoster was commonly associated with systemic disorders and the treatment durat,ion was prolonged in associated diseases. Acyclovir has a significant effect in shortening the treatment duration. Postherpetic neuralgia was the most common complication of herpes zoster and was observed most frequently in the ophthalmic branch of trigeminal nerve.