Korean J Pain.  2015 Jul;28(3):177-184. 10.3344/kjp.2015.28.3.177.

Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment

• Jeon YH

• KMID: 2149461
• DOI: http://doi.org/10.3344/kjp.2015.28.3.177

Abstract

Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.

Keyword

Analgesic; Herpes zoster; Intervention; Postherpetic neuralgia; Vaccination; Varicella zoster virus

MeSH Terms

Analgesics, Opioid
Anticonvulsants
Antidepressive Agents
Antiviral Agents
Capsaicin
Early Diagnosis
Exanthema
Ganglia, Sensory
Herpes Zoster*
Herpesvirus 3, Human
Immunity, Cellular
Incidence
Lidocaine
Neuralgia, Postherpetic*
Risk Factors
Vaccination
Analgesics, Opioid
Anticonvulsants
Antidepressive Agents
Antiviral Agents
Capsaicin
Lidocaine

Figure

• 

  Fig. 1 The natural progression of herpes zoster and postherpetic neuralgia (PHN).

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