European consensus‐based (S2k) Guideline on the Management of Herpes Zoster – guided by the European Dermatology Forum (<scp>EDF</scp>) in cooperation with the European Academy of Dermatology and Venereology (<scp>EADV</scp>), Part 1: Diagnosis

Werner, Ricardo Niklas; Nikkels, Arjen F.; Marinović, Branka; Schäfer, Michael; Czarnecka‐Operacz, Magdalena; Agius, Andee; Bata‐Csörgő, Zsuzsanna; Breuer, Judith; Girolomoni, Giampiero; Gross, Gerd; Langan, Sinéad; Lapid-Gortzak, Ruth; Lesser, T. H. J.; Pleyer, Uwe; Sellner, Johann; Verjans, Georges M. G. M.; Wutzler, Peter; Dressler, Corinna; Erdmann, R.; Rosumeck, Stefanie; Nast, Alexander

doi:10.1111/jdv.13995

Cited by 73 publications

(89 citation statements)

References 105 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our outcome was not based on standardised diagnostic criteria, which is a limitation, and there is no information available on how each zoster diagnosis was made, but in clinical practice in the UK, zoster is usually diagnosed based on observing a characteristic unilateral rash with dermatomal distribution rather than laboratory testing (Forbes et al , 2014), as per recent guidelines (Werner et al , 2017). …”

Section: Discussionmentioning

confidence: 99%

Herpes zoster risk after 21 specific cancers: population-based case–control study

et al. 2017

View full text Add to dashboard Cite

Background:Some malignancies are known to be associated with increased risk of herpes zoster, but little is known about how associations between cancer and subsequent zoster risk vary by cancer site, by time since cancer diagnosis, and by age.Methods:An age-, sex-, calendar time-, and practice-matched case–control study, nested in the broadly UK representative Clinical Practice Research Datalink (CPRD) primary care database, was analysed using conditional logistic regression to estimate the association between 21 of the most common specific malignancies and subsequent zoster risk. We adjusted for comorbid conditions and other potential confounders, and investigated effect modification by age and time since malignancy diagnosis.Results:A total of 192 081 adult zoster patients and 732 035 controls were included. Malignancy overall was positively associated with zoster risk (adjusted OR 1.29, 95% CI 1.27–1.32), and the association was especially strong for haematological malignancies (OR 2.46, 2.33–2.60). Among specific malignancies, there was evidence that oral, oesophageal, stomach, colorectal, lung, breast, ovarian, prostate, kidney, bladder, and CNS cancers, as well as lymphoma, myeloma, and leukaemia were associated with increased zoster odds (P⩽0.05 in each case), but the magnitude of associations varied widely. The association was typically strongest within 2 years of malignancy diagnosis and decreased with older age for both haematological and solid malignancies.Conclusions:Several cancers were associated with an increased risk of zoster, particularly within the first 2 years after diagnosis and among younger individuals. Knowledge that patients with a recent diagnosis of cancer are at high risk of zoster may encourage initiation of antiviral therapy earlier in the course of zoster when the benefits are greater. Evaluation of whether patients diagnosed with cancer would benefit from early zoster vaccination is warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Herpes zoster risk after 21 specific cancers: population-based case–control study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In most cases, the diagnosis of herpes zoster can be confirmed clinically by the presence of herpetiform-grouped vesicles and unilateral localization within a dermatome, in combination with pain and paresthesia 3. In the present case, a severe zoster with delayed and minimal response to treatment was the red flag for a serious underlying disorder in a patient previously healthy and capable.…”

Section: Discussionmentioning

confidence: 56%

Severe atypical herpes zoster as an initial symptom of fatal myelodysplastic syndrome with refractory anemia and blast excess (RAEB II)

Wollina

Hansel

Baunacke

et al. 2017

CCID

View full text Add to dashboard Cite

Herpes zoster is a common disease caused due to varicella zoster virus (VZV) infection with increasing incidence by age. If the patient has a severe, extended, or treatment-recalcitrant course of herpes zoster, this must be a red flag to search for underlying pathologies. Here, we report about a 64-year-old male patient with diabetes, who came to our emergency department because of general malaise, fever, chills, and a pronounced nuchal and facial swelling on the left side. Based on herpetiform-grouped vesicles and yellowish crusts, an impetiginized facial herpes zoster was diagnosed, and combined antiviral and antibiotic treatment was initiated. He was HIV negative. Despite intensified treatment, his situation worsened. We observed blasts in peripheral blood, but bone marrow biopsy was initially denied. Some days later after deterioration of his disease, he accepted further diagnostics. A myelodysplastic syndrome with blast excess (refractory anemia and blast excess II, RAEB II) could be confirmed. The following translocations were detected: t(2;12)(p13; q13) and t(6;9)(p22;q34). REAB II has an unfortunate prognosis. Cytoreductive treatment was initiated by the hematooncologist. Unfortunately, the patient deceased due to septic shock.

show abstract

mentioning

confidence: 99%

“…Herpes zoster (HZ) results from reactivation of the latent varicella zoster virus after the primary infection . Especially for elderly patients, when cell‐mediated immunity wanes, common symptoms of HZ appear, primarily as pain in a dermatomal distribution with a burning, sharp pain sensation (paresthesia) and itching, in addition to development of a vesicular rash . When reactivation in 1 or more dorsal root ganglia occurs, a unilateral thoracic dermatome most frequently occurs (55%), followed by trigeminal nerve (20%), cervical (11%), lumbar (13%), and sacral (2%) dermatomes .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effect of Ultrasound‐Guided Intercostal Nerve Block Versus Fluoroscopy‐Guided Epidural Nerve Block in Patients With Thoracic Herpes Zoster: A Comparative Study

Lee

Park

Moon

et al. 2018

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives To compare the efficacy of a conventional fluoroscopy‐guided epidural nerve block and an ultrasound (US)‐guided intercostal nerve block in patients with thoracic herpes zoster (HZ). Methods This work was a comparative study of 38 patients with thoracic HZ pain and a chest wall herpetic eruption, aged 18 years or older, with pain intensity of 5 or greater on a numeric rating scale (NRS) for less than a 1‐month duration. Patients were consecutively enrolled and assigned to 2 groups in which the intervention was either the US‐guided intercostal nerve block or the fluoroscopy‐guided epidural nerve block approach with the addition of a 5‐mL mix of 2.5 mg of dexamethasone plus 0.5% lidocaine. The primary outcome measure was the NRS score reduction for the pain. Secondary outcomes included the duration of treatment, number of repeated injections until the final visit, and proportion of patients with pain relief after the first and final visits. Results All patients within both intervention groups showed significant pain relief on the NRS at the final follow‐up point (P < .05). There was no significant difference in the mean value of NRS improvement based on the intervention type. There was also no statistically significant difference in the duration of treatment and the frequency of injection for pain relief. Conclusions These findings showed that both the US‐guided intercostal nerve block and the fluoroscopy‐guided epidural nerve block were effective in patients with thoracic HZ. Compared data showed no significant differences in the pain reduction, duration of treatment, and frequency of injection. The US‐guided intercostal nerve block, which is more accessible than the fluoroscopy‐guided epidural nerve block, might be an alternative option for thoracic HZ.

show abstract

European consensus‐based (S2k) Guideline on the Management of Herpes Zoster – guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 1: Diagnosis

Cited by 73 publications

References 105 publications

Herpes zoster risk after 21 specific cancers: population-based case–control study

Herpes zoster risk after 21 specific cancers: population-based case–control study

Severe atypical herpes zoster as an initial symptom of fatal myelodysplastic syndrome with refractory anemia and blast excess (RAEB II)

Effect of Ultrasound‐Guided Intercostal Nerve Block Versus Fluoroscopy‐Guided Epidural Nerve Block in Patients With Thoracic Herpes Zoster: A Comparative Study

Contact Info

Product

Resources

About