Recurrent herpes zoster

Bansal, Ramesh

doi:10.1046/j.1365-4362.2001.01094-4.x

Cited by 7 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our series of 17 cases of herpes zoster in immuno‐ competent children diagnosed over a 2‐year period in an outpatient dermatology unit seems to outnumber in frequency the 21 cases recorded over a 3‐year period in a larger hospital inpatient setting (11). These findings are in line with the progressive increase in the incidence of herpes zoster in otherwise healthy children over the past decades (20,21,33,34,40–42). However, it is possible that some herpes zoster cases were misdiagnosed in the past when specific laboratory investigations were not available.…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Revisiting Childhood Herpes Zoster

Nikkels

Nikkels‐Tassoudji²,

Pierard

2004

Pediatric Dermatology

View full text Add to dashboard Cite

Herpes zoster is rare in otherwise healthy children, but it is more common in association with immunosuppression. Maternal varicella infection during pregnancy and varicella occurring in the newborn represent risk factors for childhood herpes zoster. However, some controversies persist about risk factors, diagnosis, and the natural history of childhood disease. In a 2-year prospective study, 18 children with herpes zoster were clinically diagnosed in outpatient consultations in a hospital dermatology unit. Data about age, dermatome involvement, underlying disease, and history of previous varicella were recorded. Tzanck smears, biopsy specimens, and sera were obtained from 18, 4, and 10 children, respectively. The varicella zoster virus major envelope glycoprotein gE was detected in 16 of 18 smears and all four biopsies. Herpes simplex virus I was demonstrated in one of the smears. The established risk factors for childhood herpes zoster were only found in one child. Evidence for previous full-blown varicella and varicella with few lesions was recorded in 7 and 4 of the 17 immunocompetent children, respectively. No history of varicella was recalled in 6 of 17 cases, although a serologic clue of past varicella infection (IgM negative, IgG positive) was disclosed. Recurrent herpes zoster was diagnosed in one immunocompromised child. Zoster-associated pain was localized and the disease severity remained mild in all children. Established risk factors for childhood herpes zoster were only rarely found in our series of patients. In contrast, unrecognized varicella and varicella with few lesions were frequently recorded and may represent additional risk factors for shingles in childhood. Zosteriform herpes simplex virus infections should be differentiated from childhood herpes zoster, emphasizing the importance of precise viral identification.

show abstract

Section: Discussionsupporting

confidence: 81%

“…Some reports exist of recurrent herpes zoster in adult patients (40–42), but to our knowledge, this is the first report of recurrent childhood herpes zoster. Underreporting of such cases is possible because they may be clinically misdiagnosed as HSV infection and not investigated further.…”

Section: Discussionmentioning

confidence: 72%

Revisiting Childhood Herpes Zoster

Nikkels

Nikkels‐Tassoudji²,

Pierard

2004

Pediatric Dermatology

View full text Add to dashboard Cite

show abstract

“…The plausibility, actual occurrence, and frequency of recurrent HZ have been debated. [1][2][3][4][5] Studies of HZ recurrence often focus on special populations with hematologic malignancies or exposure to chemotherapeutic or immunotoxic agents like arsenic, [6][7][8][9] or they are population studies with small numbers of cases or short follow-up periods. [10][11][12][13][14][15][16] This study assessed the rate of HZ recurrence with up to 12 years of follow-up in a population-based cohort of 1669 persons with a confirmed previous episode of HZ between January 1, 1996, and December 31, 2001.…”

mentioning

confidence: 99%

Herpes Zoster Recurrences More Frequent Than Previously Reported

Yawn

Wollan

Kurland

et al. 2011

Mayo Clinic Proceedings

201

138

View full text Add to dashboard Cite

H erpes zoster (HZ), or shingles, is usually considered a once-in-a-lifetime experience, with HZ recurrences thought to be limited to immunocompromised individuals. The plausibility, actual occurrence, and frequency of recurrent HZ have been debated. [1][2][3][4][5] Studies of HZ recurrence often focus on special populations with hematologic malignancies or exposure to chemotherapeutic or immunotoxic agents like arsenic, [6][7][8][9] or they are population studies with small numbers of cases or short follow-up periods. [10][11][12][13][14][15][16] This study assessed the rate of HZ recurrence with up to 12 years of follow-up in a population-based cohort of 1669 persons with a confirmed previous episode of HZ between January 1, 1996, and December 31, 2001. Like the index episodes, HZ recurrences were required to meet predefined diagnostic criteria of dermatomal rash and pain. [17][18][19][20] These data should provide health care professionals, insurers, and policy makers a more robust basis for practice, insurance, and policy decisions regarding prevention and treatment of HZ recurrences. PATIENTS AND METHODSWe reviewed the medical records of a community population-based cohort of people with a confirmed episode of HZ followed up for recurrence for as long as 12 years after the index episode. Recurrence rates were expressed by time from the index episode to the first recurrence and stratified by sex, age, and immune status (immunocompromised or immunocompetent) as assessed at the time of the initial or index episode of HZ. Data from the Rochester Epidemiology Project 22,23 made it possible to identify all care provided to each of these individuals by any outpatient or inpatient health care facility within the county during the follow-up period.Identification and confirmation of the index episodes of HZ have been described previously.17 Briefly summarized, the original incidence study looked at the medical records of all residents of Olmsted County, Minnesota, aged 22 years or older who, according to administrative data, presented to any health care site with an acute HZ episode between January 1, 1996, and December 31, 2001. Using detailed medical record review, we confirmed the index HZ case and collected data on HZ complications, treatment, and immune status. Any person with an administrative HZ code before the period of interest (January 1, 1996, through December 31, 2001) was excluded from the cohort in an effort to assess rates of first HZ occurrence.For this recurrence study, the medical records of all individuals with a confirmed HZ episode in the initial incidence study were reviewed from the date of their index HZ episode through December 31, 2007 (ie, a 6-to 12-year follow-up) to identify HZ recurrences. All medical records of all Olmsted County, Minnesota, health care facilities were reviewed to identify any recurrences for each individual in

show abstract

“…Herpes zoster normally presents as a vesicular dermatomal eruption from reactivation of a latent virus. I would like to expand upon the subject of recurrent herpes zoster as presented by Bansal 1 in Issue 8, Volume 40, International Journal of Dermatology .…”

mentioning

confidence: 99%

“…As a rule, repetitive dermatomal outbreaks are herpes simplex infections (and not zoster) unless proven otherwise. However, Bansal 1 may be correct in that recurrent herpes zoster exists more commonly than is appreciated.…”

mentioning

confidence: 99%