Dermatologic Manifestations of Herpes Zoster

Somayaji, Ranjani; Elliott, James A.; Sibbald, R. Gary

doi:10.1007/978-3-319-44348-5_10

Cited by 5 publications

(6 citation statements)

References 52 publications

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“…Other prodromal symptoms, such as a headache, fatigue, malaise, or low‐grade fever, occur in less than 20% of individuals . Lymph nodes that drain the affected area may also become enlarged and tender …”

Section: Clinical Presentationmentioning

confidence: 99%

“…Diagnosis of herpes zoster is typically based on clinical presentation with a reported history of varicella infection or vaccination. Symptomatology is usually sufficient for diagnosis, because common differentials such as impetigo, contact dermatitis, folliculitis, scabies, insect bites, papular urticaria, candida, dermatitis herpetiformis, and drug eruptions do not have the unique characteristics of a herpes zoster outbreak as outlined above . However, herpes simplex virus (HSV) infection may occur in a dermatomal distribution and be mistaken for herpes zoster; therefore, HSV screening may be warranted in cases of recurrent lesions.…”

Section: Diagnostic Approachesmentioning

confidence: 99%

“…For women experiencing pain or pruritis, recommended comfort measures include the use of cool, wet compresses soaked in tap water or Burrow's solution or immersion in a bath with colloidal oatmeal . Application of topical lotions or creams containing calamine, pramoxine, or menthol may be soothing and can be especially comforting when kept cool in a refrigerator . Alternatively, oral or topical diphenhydramine (Benadryl) may be used.…”

Section: Treatmentmentioning

confidence: 99%

“…9 Lymph nodes that drain the affected area may also become enlarged and tender. 10 After prodromal symptoms, an erythematous macular rash develops. These flat, reddened areas are often subtle and might otherwise go unnoticed if not for feelings of itching and irritation.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Symptomatology is usually sufficient for diagnosis, because common differentials such as impetigo, contact dermatitis, folliculitis, scabies, insect bites, papular urticaria, candida, dermatitis herpetiformis, and drug eruptions do not have the unique characteristics of a herpes zoster outbreak as outlined above. 10 However, herpes simplex virus (HSV) infection may occur in a dermatomal distribution and be mistaken for herpes zoster; therefore, HSV screening may be warranted in cases of recurrent lesions. In instances in which pain is severe along the thoracic dermatomes and lesions have not yet erupted, prodromal symptoms may seem suspicious for gallbladder disease, appendicitis, or myocardial infarction.…”

Section: Diagnostic Approachesmentioning

confidence: 99%

See 4 more Smart Citations

Herpes Zoster in Pregnancy

Schafer

Davis

Phillippi

2019

J Midwife Womens Health

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Herpes zoster (shingles) is the reactivation of dormant varicella zoster virus in individuals who previously experienced varicella infection or vaccination. Herpes zoster can occur in pregnancy, although it is rare. This case report describes the clinical presentation and diagnosis of herpes zoster and reviews current recommendations for treatment. Preventative measures and the role of immunization are discussed in addition to clinical implications for intrapartum, postpartum, and newborn care to guide practitioners in caring for women experiencing or exposed to herpes zoster in pregnancy.

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Diagnostic Approachesmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Diagnostic Approachesmentioning

confidence: 99%

See 3 more Smart Citations

Herpes Zoster in Pregnancy

Schafer

Davis

Phillippi

2019

J Midwife Womens Health

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An Evaluation of Efficacy and Safety of Commonly Prescribed Drugs and Effect of These Drugs on Quality of Sleep in Patients Suffering From Zoster‐Associated Pain

Nayak

Kapadia

Desai

et al. 2018

The Journal of Clinical Pharma

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This observational, prospective, single-center study was conducted to evaluate the efficacy and safety of commonly prescribed drugs for zoster-associated pain and their impact on quality of sleep at a tertiary care hospital in western India. Patients ≥18 years of age, newly diagnosed with zoster-associated pain were evaluated on days 0, 7, 14, 30, 60, 90, 120, 150, and 180 or until resolution of pain, whichever was earlier, using the Wong Baker FACES Pain Rating Scale, Neuropathic Pain Scale, and Insomnia Severity Index for intensity of pain, quality of pain, and quality of sleep, respectively. A total of 78 patients (46.0 [16.3] years) completed the study. They received nonsteroidal anti-inflammatory drugs (65), gabapentin (30), amitriptyline (27), and amitriptyline + gabapentin (21) for mean durations of 7.7 (3.0), 89.2 (7.2), 107.6 (46.3), and 104.5 (46) days, respectively. Improvement in the Wong Baker FACES Pain Rating Scale and Neuropathic Pain Scale score was similar among treatment groups except for a greater fall in Wong Baker FACES Pain Rating Scale score at days 7 and 120 and that in deep pain score at day 7 in combination treatment group vs the amitriptyline group. Clinically significant insomnia was detected in 35 patients at baseline and demonstrated progressive and similar improvement among groups. Treatment modification was required in 20 patients. Zoster-associated pain resolved in 69 patients. Nine adverse drug reactions, mostly mild, nonserious, and nonpreventable, were reported. To conclude, drugs commonly used for zoster-associated pain are effective and well tolerated. These have a similar effect on pain and quality of sleep, except for a possible greater effect of combination treatment in the early phase of intense and deep pain.

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Risk Factors for Herpes Zoster Infection: A Meta-Analysis

Marra

Parhar

Huang

et al. 2020

Open Forum Infectious Diseases

173

146

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Background The burden of herpes zoster (HZ) is significant worldwide, with millions affected and the incidence rising. Current literature has identified some risk factors for this disease; however, there is yet to be a comprehensive study that pools all evidence to provide estimates of risk. Therefore, the purpose of this study is to identify various risk factors, excluding immunosuppressive medication, that may predispose an individual to developing HZ. Methods The literature search was conducted in MEDLINE, EMBASE, and Cochrane Central, yielding case control, cohort, and cross-sectional studies that were pooled from January 1966 to September 2017. Search terms included the following: zoster OR herpe* OR postherpe* OR shingle* AND risk OR immunosupp* OR stress OR trauma OR gender OR ethnicity OR race OR age OR diabetes OR asthma OR chronic obstructive pulmonary disease OR diabetes. Risk ratios (RRs) for key risk factors were calculated via natural logarithms and pooled using random-effects modeling. Results From a total of 4417 identified studies, 88 were included in analysis (N = 3, 768 691 HZ cases). Immunosuppression through human immunodeficiency virus/acquired immune deficiency syndrome (RR = 3.22; 95% confidence interval [CI], 2.40–4.33) or malignancy (RR = 2.17; 95% CI, 1.86–2.53) significantly increased the risk of HZ compared with controls. Family history was also associated with a greater risk (RR = 2.48; 95% CI, 1.70–3.60), followed by physical trauma (RR = 2.01; 95% CI, 1.39–2.91) and older age (RR = 1.65; 95% CI, 1.37–1.97). A slightly smaller risk was seen those with psychological stress, females, and comorbidities such as diabetes, rheumatoid arthritis, cardiovascular diseases, renal disease, systemic lupus erythematosus, and inflammatory bowel disease compared with controls (RR range, 2.08–1.23). We found that black race had lower rates of HZ development (RR = 0.69; 95% CI, 0.56–0.85). Conclusions This study demonstrated a number of risk factors for development of HZ infection. However, many of these characteristics are known well in advance by the patient and clinician and may be used to guide discussions with patients for prevention by vaccination.

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Dermatologic Manifestations of Herpes Zoster

Cited by 5 publications

References 52 publications

Herpes Zoster in Pregnancy

Herpes Zoster in Pregnancy

An Evaluation of Efficacy and Safety of Commonly Prescribed Drugs and Effect of These Drugs on Quality of Sleep in Patients Suffering From Zoster‐Associated Pain

Risk Factors for Herpes Zoster Infection: A Meta-Analysis

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