A Comparative Study of the Clinical Findings Associated with Herpes Zoster and According to Age

Kim, Chong Gue; Na, Chan Ho; Choi, Kyu Chul; Shin, Bong Seok

Abstract

BACKGROUND
Patients with herpes zoster generally complain typical manifestations, including prodromal pain, a grouped vesicular rash and prickling pain on unilateral dermatomes. However, there have been a few reports showing clinical differences by age.
OBJECTIVE
The purpose of this study was to evaluate the clinical differences among the various aged populations that suffer with herpes zoster.
METHODS
The medical records of 921 patients who were diagnosed with herpes zoster at our institution between January 2002 and December 2008 were reviewed, and if necessary, telephone interviews were done. According to the age groups as classified with a decade-scale, the data was assessed with respect to gender, seasonal occurrence, the dermatomal distribution, prodromal pain, the chief symptom, the range of lesion, underlying diseases and postherpetic neuralgia.
RESULTS
The mean age of the subjects was 57.7 and the ratio of males to females was 1:1.4. The proportions of female patients gradually increased in the over 40 year-old group (p<0.001). As one grows older, there is a trend for a higher occurrence of herpes zoster in winter (p=0.011). The likelihood of attacks on the trigeminal dermatome appeared to increase with age, but that of the spinal dermatomes, including the cervical, thoracic and lumbosacral area, showed a decrease with age (p=0.01). The rate of prodromal pain was higher with age (p=0.004). The rate of prickling pain increased with age, but that of pruritus decreased with age (p=0.001). The presence of widely involved lesion (p=0.013), an underlying disease (p<0.001) and postherpetic neuralgia (p<0.001) increased with age.
CONCLUSION
The results of this study demonstrated that the clinical findings associated with herpes zoster were not always consistent in different aged populations. The rate of female patients, occurrence in winter, an attack on the trigeminal dermatome, prodromal pain, prickling pain, larger lesion, underlying disease and postherpetic neuralgia showed a tendency to increase with age.