scholarly journals Clinical study of herpes zoster in 109 patients in central referral hospital, Gangtok

2019 ◽  
Vol 5 (4) ◽  
pp. 849
Author(s):  
Rukma L. Sharma ◽  
Rekha Sharma
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root ◽  
Skin Lesions ◽  
Age Group ◽  
Female Ratio ◽  
Varicella Zoster ◽  
Single Nerve ◽  
Male Female Ratio ◽  
The Common

<p class="abstract"><strong>Background:</strong> Herpes zoster results from the reactivation of varicella-zoster virus lying dormant in the dorsal root ganglia following an earlier primary infection (chickenpox), usually in childhood. The reactivation occurs due to multifactorial causes leading to decreased immunity.</p><p class="abstract"><strong>Methods:</strong> This study was conducted on 109 cases of herpes zoster. Patient’s particulars were noted. A detailed history was recorded; morphology, the site and side of skin lesions were recorded. Any other associated diseases were noted.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 109 patients 66 were male and 43 were female. The total of 53 (48.6%) patients were under the age of 40 years and 56 (51.4%) patients above 40 years. Bhutias were affected in highest number (18.4%) followed by Sharma community (15.6%). The ophthalmic division of trigeminal nerve was the most commonly affected single nerve with 13.8% followed by T10 and T7 dermatome at 9.17% and 7.3% respectively. Thoracic nerves the most commonly involved thoracic nerves with 44 cases. Single dermatomal eruptions were found in 55 patients. The dissemination of herpes zoster was although very rare but was present in three patients. Type 2 diabetes mellitus was the common associated systemic illness with 10.09% of patients.</p><p class="abstract"><strong>Conclusions:</strong> From this study it was revealed that both young adults and older age group people were affected almost equally. The male: female ratio was 1.5:1 with Bhutia community being mostly affected. Thoracic dermatome was the most common dermatome involved and in half the patients some form of associated disease noted.</p>

scholarly journals A study on clinical characteristics of herpes zoster in a tertiary care center

2017 ◽  
Vol 3 (1) ◽  
pp. 79
Author(s):  
Rachana R. ◽  
Shivaswamy K. N. ◽  
Anuradha H. V.
Keyword(s):  
Herpes Zoster ◽  
Clinical Characteristics ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Age Group ◽  
Female Ratio ◽  
Varicella Zoster ◽  
Medical College ◽  
Male To Female

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Herpes zoster (HZ), also known as shingles, derived from the Latin word Cingulum, for “girdle”. This is because a common presentation of HZ involves a unilateral rash that can wrap around the waist or torso like a girdle. HZ results due to reactivation of an earlier latent infection with the varicella zoster virus (VZV) in dorsal root ganglia. It occurs at all age groups, common over 60 years of age. It is estimated that in non-immune populations, approximately 15 cases per 1000 people occur per year. The objective of the study was to study the clinical characteristics in patients with uncomplicated herpes zoster.</span></p><p class="abstract"><strong>Methods:</strong> A total of 72 patients attending dermatology OPD at Ramaiah medical college between June 2013 to September 2014 were recruited after obtaining informed consent. A detailed history regarding onset of rash, pain, progression, duration and distribution of the lesions were recorded. Demographic information including age, sex, and any other co morbidities noted. Tzanck smear and serology for HIV was done where-ever necessary.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Of the 72 patients, females outnumbered males [M=35(48.61%), F=37 (51.39%)] with male to female ratio of 0.9 to 1. The mean age of presentation was 58±18 years. Majority of the patients (54%) were in the age group of 51 to 70 years followed by 31-50 years (25%). Least number of cases (9%) was in the age group of 21 to 30 years. Of the 72 subjects, thoracic involvement was noted in 30.6%, followed by lumbar (22%), and trigeminal (16%). Cervical (4%) and sacral (2%) involvement was the least. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Herpes zoster commonly occurs in old age and the presenting symptom being pain and burning sensation. Thoracic dermatome is the commonest site. Immunocompromised states like diabetes, malignancy and HIV can increase the risk of developing herpes zoster.</span></p>

Herpes Zoster and Postherpetic Neuralgia

2018 ◽  
pp. 93-98
Author(s):  
Jianguo Cheng
Keyword(s):  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Dorsal Root ◽  
Skin Lesions ◽  
Intercostal Nerve ◽  
Intrathecal Therapy ◽  
Nerve Blocks ◽  
Varicella Zoster ◽  
Epidural Injections ◽  
History Of

Herpes zoster is caused by reactivation of the latent varicella zoster virus (VZV) that causes chicken pox. VZV remains dormant in the dorsal root and cranial ganglia and can reactivate later in a person’s life and cause herpes zoster, which appears predominantly in older adults, but may also occur in those that are immunocompromised. Postherpetic neuralgia (PHN) is defined as pain in the affected dermatome that is still present 1 month after development of the vesicles. Adults older than 50 should receive the herpes zoster vaccine as part of routine medical care. Shingrix is a new vaccine recently approved and recommended by the FDA, which is a non-live, subunit vaccine. In contrast to Zostavax, Shingrix is 97% effective against shingles and 91% effective against PHN for people 50 and older. The diagnosis of herpes zoster can be made on the basis of characteristic skin lesions and pain and itching in the involved dermatome. During the acute phase, an antiviral given within 72 hours of onset helps reduce pain and complications and shorten the course of the disease. The diagnosis of PHN is based on a history of herpes zoster, typical dermatomal distribution of the pain, and hyperalgesia and/or allodynia on physical examination. First-line pharmacotherapy includes gabapentin or pregabalin, tricyclic antidepressants, and SNRIs. Combination therapies are often necessary. Interventional options such as epidural injections, paravertebral blocks, selective nerve root blocks, sympathetic nerve blocks, intercostal nerve blocks, trigeminal nerve blocks, spinal cord or dorsal root ganglion stimulation, and intrathecal therapy may be considered in refractory cases.

scholarly journals 996. The Potential for Reducing Opioid and Analgesic Prescriptions Via Herpes Zoster Vaccination

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S527-S527
Author(s):  
Jean-Etienne Poirrier ◽  
Justin Carrico ◽  
Jessica K DeMartino ◽  
Katherine A Hicks ◽  
Jeffrey J Stoddard ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Age Group ◽  
Opioid Prescription ◽  
Varicella Zoster ◽  
Effectiveness Model ◽  
Prescription Rates ◽  
Medication Exposure ◽  
The Mean ◽  
The Impact ◽  
Analgesic Use

Abstract Background Herpes zoster (HZ), or shingles, is a common neurocutaneous disease caused by the reactivation of latent varicella zoster virus that often includes rash and neuropathic pain that may last for months. Opioids and other analgesics may be prescribed. Recombinant zoster vaccine (RZV) is preferentially recommended for the prevention of HZ in adults aged 50 years and older. This study aimed to assess the impact of RZV vaccination on opioid and other analgesic prescription-related outcomes. Methods Estimates of analgesic prescription rates (opioids, benzodiazepines, and other analgesics) among HZ cases were established using Truven claims data from 2012-2018 for adults aged 50 years and older. HZ case avoidance with RZV vaccination was calculated using a previously published cost-effectiveness model. This data was included in a calculator assessing the impact of RZV vaccination on analgesic prescription-related outcomes (compared to no vaccination). Results Between 24.4% and 28.0% of HZ cases in the observed claims had at least one opioid prescription, dependent on age group (4.5%-6.5% and 8.6%-19.6% for benzodiazepines and other analgesics, respectively). The mean number of opioid prescriptions per person in each age group with at least one opioid prescription was between 1.7 and 1.9 (1.7-2.3 and 1.7-2.0 prescriptions for benzodiazepines and other analgesics, respectively). Assuming a 1-million-person population and 65% RZV coverage, the calculator predicts RZV vaccination will prevent 75,002 cases of HZ and will prevent 19,311 people from being prescribed at least 1 HZ-related opioid, 4,502 people from being prescribed benzodiazepines, and 12,201 people from being prescribed other analgesics. Additionally, 34,520 HZ-related opioid prescriptions will be avoided (9,413 benzodiazepine prescriptions; 22,406 other analgesic prescriptions). Conclusion HZ is associated with high levels of opioid, benzodiazepine, and other analgesic use. Primary prevention of HZ by vaccination could potentially reduce opioid and other medication exposure. Disclosures Jean-Etienne Poirrier, PhD, MBA, The GSK group of companies (Employee, Shareholder) Justin Carrico, BS, GlaxoSmithKline (Consultant) Jessica K. DeMartino, PhD, The GlaxoSmithKline group of companies (Employee, Shareholder) Katherine A. Hicks, MS, BSPH, GlaxoSmithKline (Scientific Research Study Investigator, GSK pays my company for my contractual services.) Saurabh P. Nagar, MS, RTI Health Solutions (Employee) Juliana Meyers, MA, GlaxoSmithKline (Other Financial or Material Support, This study was funded by GlaxoSmithKline.)

scholarly journals Varicella Zoster Virus-Associated Meningitis as a Rebound Varicella Zoster Disease after Antiviral Discontinuation

2021 ◽  
pp. 148-153
Author(s):  
Tetsuko Sato ◽  
Takenobu Yamamoto ◽  
Yumi Aoyama
Keyword(s):  
Herpes Zoster ◽  
Early Diagnosis ◽  
Varicella Zoster Virus ◽  
Immunosuppressive Therapy ◽  
Unusual Case ◽  
Cranial Nerves ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Aggressive Treatment ◽  
Varicella Zoster

Varicella zoster virus (VZV)-associated meningitis is usually progressive and can be fatal, and early diagnosis and aggressive treatment with intravenous antivirals such as acyclovir (ACV) are required in immunocompromised patients. Patients receiving corticosteroids and immunosuppressive therapy have a significantly higher risk of VZV-associated meningitis. In this report, we describe an unusual case of herpes zoster (HZ) in a young woman who was first diagnosed during tapering of prednisone for dermatomyositis. The skin lesions affected the left L2 and L3 dermatomes, which is unusual in VZV-associated meningitis. Despite showing a good rapid response to antivirals, she developed VZV-associated meningitis immediately after discontinuation of ACV. This phenomenon is often called rebound VZV reactivation disease and occurs after discontinuation of antivirals. This case was notable in that the affected dermatomes were distant from the cranial nerves. Thus, progression of HZ to VZV reactivation-associated meningitis can occur even in appropriately treated HZ patients. Continuation of antivirals beyond 1 week in patients on immunosuppressive therapy may be associated with a decreased risk of severe rebound VZV disease, such as VZV-associated meningitis.

scholarly journals Prevention of Post-herpetic Neuralgia from Dream to Reality: A Ten-step Model

2017 ◽  
Vol 2 (20;2) ◽  
pp. E209-E220 ◽  
Author(s):  
Mohamed Younis Makharita
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root ◽  
Risk Groups ◽  
Substantial Effect ◽  
Viral Reactivation ◽  
Post Herpetic Neuralgia ◽  
Suggested Approach ◽  
Varicella Zoster ◽  
Acute Herpes Zoster ◽  
Step Model

Herpes zoster (HZ) is a painful, blistering skin eruption in a dermatomal distribution caused by reactivation of a latent varicella zoster virus in the dorsal root ganglia (DRG). Post-herpetic neuralgia (PHN) is the most common complication of acute herpes zoster (AHZ). Severe prodrome, greater acute pain and dermatomal injury, and the density of the eruption are the risk factors and predictors for developing PHN. PHN has a substantial effect on the quality of life; many patients develop severe physical, occupational, social, and psychosocial disabilities as a result of the unceasing pain. The long-term suffering and the limited efficacy of the currently available medications can lead to drug dependency, hopelessness, depression, and even suicide. Family and society are also affected regarding cost and lost productivity. The pathophysiology of PHN remains unclear. Viral reactivation in the dorsal root ganglion and its spread through the affected nerve result in severe ganglionitis and neuritis, which induce a profound sympathetic stimulation and vasoconstriction of the endoneural arterioles, which decreases the blood flow in the intraneural capillary bed resulting in nerve ischemia. Our rationale is based on previous studies which have postulated that the early interventions could reduce repetitive painful stimuli and prevent vasospasm of the endoneural arterioles during the acute phase of HZ. Hence, they might attenuate the central sensitization, prevent the ischemic nerve damage, and finally account for PHN prevention. The author introduces a new Ten-step Model for the prevention of PHN. The idea of this newly suggested approach is to increase the awareness of the health care team and the community about the nature of HZ and its complications, especially in the high-risk groups. Besides, it emphasizes the importance of the prompt antiviral therapy and the early sympathetic blockades for preventing PHN. Key words: Acute herpes zoster, prevention, post-herpetic neuralgia, sympathetic blockade, tenstep model

scholarly journals Outcome of Probing for Congenital Naso-Lacrimal Duct Obstruction

2015 ◽  
Vol 14 (1) ◽  
pp. 36-37
Author(s):  
Mozammel Hoq Sharife ◽  
M Jalal Uddin ◽  
Mostak Ahmed
Keyword(s):  
Nasolacrimal Duct ◽  
Age Group ◽  
Lacrimal Duct ◽  
Female Ratio ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Male Female Ratio ◽  
Group A ◽  
Level Hospital

Objective: The study was conducted to evaluate outcome of probing for congenital nasolacrimal duct obstruction. It was an interventional study at a tertiary level hospital of Chittagong. Methods: The study was conducted during April 2009 to March 2013 (04 years). Total 120 eyes of 102 children of 1-3 years age group were probed. Minimum follow up time was 01 year. Results: 110 eyes fully cured, 05 eyes needed re-probing, 03 eyes needed Dacrocystorhinostomy operation (DCR) and 02 cases were dropped out. Male female ratio was 72 (60%) and 48 (40%). Conclusion: Outcome of probing is better among 1-2 years age group than that of 2- 3 years age group. A discussion is made with updated literature review. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22879 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 36-37

scholarly journals Epidemiological Profile of the Head- Neck Pathologies in a Peripheral Referral Institute

2019 ◽  
Vol 27 (2) ◽  
pp. 113-120
Author(s):  
Sabyasachi Ghosh ◽  
Tarak Nath Saha ◽  
Indranil Sen
Keyword(s):  
Head And Neck ◽  
Histopathological Examination ◽  
Neck Region ◽  
Head And Neck Cancers ◽  
Base Line ◽  
Age Group ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Epidemiological Profile ◽  
Head Neck

Introduction   Head and neck lesions encompass a multitude of disorders which can be broadly classified into two groups: Benign and Malignant. Overall 57.5% of global head and neck cancers comes from Asia itself and India alone constitutes 30% of it. Therefore, it is of prime essence that need based and coordinated research for understanding the threats to the nation from chronic diseases such as head and neck cancers and ways to defy such threats should gain the utmost importance. The present study attempts to present the epidemiological profile of the patients attending a peripheral referral institute of this state with head-neck pathologies and has undergone a histopathological examination of their lesions within a period of three years period (2016-18) based on the histopathological evidences. Materials and Methods The accumulated data regarding the aforesaid patients as per records of the histopathological reports available in the Department of Pathology was used as the primary material and the interrelation of different epidemiological parameters were studied using the statistical methods Results Six hundred and eighty seven cases from the head and neck region were analysed during this three-year period. Age range was from 3 years to 96 years with maximum cases in the age group of 20-29 years (16.1%). The Male: Female ratio in our study was 1.34:1 (Males 394, Females 293). In this study, 38.8% benign, 32.46% malignant, 25.32% inflammatory and 3.3% congenital cases were recorded. Maximum number of benign lesions was in the age group of 10-39 years. Malignancies were noted to be higher in ages 40 years and above. Squamous cell carcinoma was the most common malignancy observed. Conclusion  Specific data obtained like this from histopathological records is helpful in evaluating patterns of head and neck lesions and augment the base line data of institute and the region.

scholarly journals Clinical Study on Outcome of Treatment for Herpes Zoster

2021 ◽  
Author(s):  
Kishan Rasubhai Ninama ◽  
Rashmi Samir Mahajan ◽  
Atmakalyani Rashmi Shah ◽  
Apexa Prakash Jain
Keyword(s):  
Herpes Zoster ◽  
Lupus Erythematosus ◽  
De Novo ◽  
Clinical Manifestations ◽  
Pemphigus Vulgaris ◽  
Clinical History ◽  
Skin Lesions ◽  
Enzyme Linked Immunosorbent Assay ◽  
Oral Acyclovir ◽  
Varicella Zoster

Introduction: Herpes Zoster (HZ) is caused by reactivation of Varicella Zoster Virus (VZV). It is characterised by occurrence of grouped vesicles on erythematous base which involves the entire dermatome innervated by a single spinal or cranial sensory ganglion and is associated with radicular pain. Antivirals (Acyclovir, Famciclovir and Valacyclovir) started within 72 hours of onset of lesions are the agents of choice. Aim: To study the clinical manifestations, comorbidities, efficacy and safety of Acyclovir, complications and sequelae associated with HZ. Materials and Methods: A 3-year longitudinal cohort study was conducted in 212 adult patients (>18 years of age) suffering with HZ in the Department of Dermatology, Dhiraj General Hospital, Pipariya, Gujarat, India. In this study 212 patients with HZ were prescribed oral Acyclovir in a dose of 800 mg 5 times a day for 7 days. All patients were analysed in terms of clinical manifestations, pre-existing co-morbidities and incidence of complications. The clinical history and findings were recorded in a prestructured proforma. All patients were subjected to cytological examination (Tzanck smear) and Human immunodeficiency viruses (HIV) testing Enzyme-Linked Immunosorbent Assay (ELISA). Diagnosis was made primarily on the basis of clinical findings and presence of multinucleated giant cells in Tzanck smear. All the patients were treated with Oral Acyclovir. Cases were followed-up fortnightly for six weeks and evaluated for relief of symptoms, treatment outcome and complications/sequelae. Results: Two hundred and twelve cases were studied. One hundred and forty-two cases were in the 4th and 5th decades of life. Sixty-three cases had comorbidities like diabetes mellitus in 31, autoimmune diseases like pemphigus vulgaris, systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel disease in 19 and AIDS in 8 cases. Five cases had malignancy/lymphomas and were receiving chemotherapy for the same. In the majority, HZ occurred de novo without any comorbidities. The most common dermatomes involved were cervical and thoracic. Out of 212 cases Oral Acyclovir 800 mg was well tolerated by 74. Most common complication was Postherpetic Neuralgia (PHN), seen in 80 cases. Conclusion: The treatment of HZ with Oral Acyclovir 800 mg 5 times a day for 7 days is efficacious for healing of skin lesions and also reduces the chances of PHN if instituted within 72 hours.

scholarly journals An An Unusual Presentation of Varicella Meningitis: A Case Report and Review of the Literature

2019 ◽  
Vol 14 (4) ◽  
pp. e39-e42
Author(s):  
Matthew Patel ◽  
Rachel Bierbrier ◽  
Katina Tzanetos
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root ◽  
Primary Infection ◽  
Acute Infection ◽  
Neurologic Complications ◽  
Review Of The Literature ◽  
Healthy Male ◽  
Varicella Zoster ◽  
The Face ◽  
Zoster Sine Herpete

Varicella Zoster Virus (VZV) primary infection causes chickenpox, often in young children, and is characterized by vesicular lesions on the face, limbs and trunk. In immunocompetent hosts, the infection is usually mild and self-limited. Following infection the virus remains dormant in the dorsal root ganglia but can reactivate, replicate and cause Herpes zoster (shingles), a painful vesicular eruption in a single dermatomal distribution.1, 2 Although Herpes zoster typically presents with this characteristic rash, there are reports of zoster sine herpete herpes zoster without the presence of a rash but with pain.1 Neurologic complications, including meningitis, encephalitis or myelitis can occur with acute infection or reactivation of VZV, but is uncommon in immunocompetent hosts, and even more rare without an exanthema.3 This report describes a case of reactivation VZV meningitis without any viral exanthema in a young healthy male.  

Sign in / Sign up

Export Citation Format

Share Document