Clinical and morphological characteristics of herpes zoster - A study from tertiary care centre

Abstract

Objective To determine incidence, pattern of occurrence and evolution of herpes zoster.Methods This was an analytical study conducted between June 2013 and June 2015. All cases of herpes zoster visiting Dermatology outpatient department of district government hospital Gulbarga were taken into study. Detail clinical history and examination were carried out in all patients. Tzanck smear and skin biopsy were done wherever required. Specific blood investigations were done to establish provocative factors if any.Results Total 240 patients were included in the study. Incidence of herpes zoster was highest 58 (24.2%) in the age group of 30-40 years. Majority of herpes zoster 170 (70.8%) occurred spontaneously. Provocative factors were noted in 70 (29.1%) cases, which included immunosuppression due to long-term steroids, chemotherapy, malignancy, diabetes mellitus, human immunodeficiency virus (HIV) infection, and chronic renal failure. Thoracic dermatome was most commonly involved 106 (44.2%) followed by cranial 59 (24.6%), cervical 30 (12.5%), lumbar 22 (9.2%) and sacral 15 (6.2%). More than one dermatome was involved in 8 (3.3%) cases. Complications such as secondary bacterial infection, postherpetic neuralgia and motor weakness were noted in 81 (33.8%) patients. Majority of patients resolved in 7-14 days except in patients with immunocompromised status.Conclusion Steroid intake was most common provocative factor and pain was most common presenting symptom. Thoracic dermatome was most commonly involved followed by cranial.