Ann Dermatol.  2018 Apr;30(2):158-163. 10.5021/ad.2018.30.2.158.

Usefulness of Inflammatory Markers for the Prediction of Postherpetic Neuralgia in Patients with Acute Herpes Zoster

• Kim JY
• Park GH
• Kim MJ
• Sim HB
• Lee WJ
• Lee SJ
• Kim SW
• Jeon YH
• Jang YH
• Kim DW

• KMID: 2414676
• DOI: http://doi.org/10.5021/ad.2018.30.2.158

Abstract

BACKGROUND
Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN).
OBJECTIVE
In this study, we investigated the value of serum levels of various inflammatory markers in acute herpes zoster (HZ) as predictors for the development of PHN.
METHODS
A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual analogue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were obtained at the initial visit. Correlations between the levels of each inflammatory marker and the development of PHN were evaluated.
RESULTS
Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lymphocyte count also showed significant correlations in multivariate analysis. ESR level showed stronger correlations with development of PHN than levels of CRP and lymphocyte count.
CONCLUSION
In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed.

Keyword

Herpes zoster; Inflammation; Postherpetic neuralgia

MeSH Terms

Blood Cell Count
Blood Sedimentation
C-Reactive Protein
Diagnosis
Herpes Zoster*
Herpesvirus 3, Human
Humans
Inflammation
Lymphocyte Count
Multivariate Analysis
Neuralgia, Postherpetic*
Neurons
C-Reactive Protein

Figure

• 

  Fig. 1 Receiver operating characteristic curves of the models adding each inflammatory marker (red) compared with that of a reference model using age and initial pain visual analogue scale (blue, area under curve [AUC]=0.85); (A) erythrocyte sedimentation rate (AUC=0.90, p=0.049), (B) C-reactive protein (AUC=0.89, p=0.221), and (C) lymphocyte count (AUC=0.88, p=0.284).

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