Korean J Dermatol.  2020 May;58(4):245-253.

Clinical Features and Risk Factors of Facial Herpes Zoster: Ocular Complications and Postherpetic Neuralgia

• Jeong HH
• Oh SY
• Lee HJ
• Heo EP
• Go JW

Abstract

Background
Facial herpes zoster can be accompanied by several complications. In particular, postherpetic neuralgia (PHN) and ocular complications (OCs) are relatively common. Both PHN and OC are of interest because they can lower the quality of life.
Objective
This study aimed to evaluate the clinical features of facial herpes zoster and to assess the risk factors of OCs and PHN.
Methods
We analyzed the medical records of 146 patients with facial herpes zoster from January 2014 to May 2019. We assessed the proportion of OCs and PHN in patients with facial herpes zoster according to several clinical factors, including age, sex, dermatomal distribution, delayed time to treatment, and associated systemic conditions. OCs were divided into mild and severe ocular complications (SOC) by ophthalmologic diagnosis.
Results
The incidence rate of OCs (83.8%) and SOC (37.8%) were highest in patients in their 70s. Herpes zoster involving the ophthalmic and maxillary branches of the trigeminal nerves showed a significantly higher incidence rate of OCs and SOC than those involving only the ophthalmic branch (p=0.031, p=0.025). Patients who received antiviral treatment within 4 days showed lower rates of OCs and SOC than patients who received treatment after 5 days (p＜0.001, p=0.003). The incidence of PHN was significantly higher in those over 60 years old, when both the ophthalmic and maxillary branches were involved, and for those treated more than 4 days after the onset.
Conclusion
To decrease the risk of OCs and PHN in facial herpes zoster, it is important to provide early antiviral treatment and appropriate ophthalmologic consultation.

Keyword

Facial herpes zoster; Ocular complications; Postherpetic neuralgia