Clinical Observation of Bacterial Studies in the Skin Lesions of Patients with Herpes Zoster.
- Author:
Jong Keun SEO
1
;
Sang Min LEE
;
Sook Kyung LEE
Author Information
1. Department of Dermatology, Maryknoll Hospital, Busan, Korea. karrot75@hanmail.net
- Publication Type:Original Article
- Keywords:
Herpes zoster;
Bacterial study
- MeSH:
Acute Pain;
Bacterial Infections;
Cicatrix;
Diabetes Mellitus;
Female;
Herpes Zoster*;
Humans;
Incidence;
Male;
Neuralgia;
Neuralgia, Postherpetic;
Skin*;
Staphylococcus epidermidis;
Trigeminal Nerve;
Wound Healing;
Wounds and Injuries
- From:Korean Journal of Dermatology
2007;45(10):1031-1040
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The impaired barrier function on the skin lesion of herpes zoster can contribute to the development of secondary bacterial infection. Although bacterial infection may delay wound healing and cause scarring, there is no available data about secondary bacterial infection of patients with herpes zoster. OBJECTIVE: We investigated the relationship between the result of bacterial studies and several clinical manifestations of herpes zoster including age, dermatomal distribution, duration of the skin lesion, severity of acute pain, incidence of postherpetic neuralgia, and diabetes mellitus. METHODS: We classified 377 patients with herpes zoster, according to the results of bacterial studies of the wound, conducted by means of bacterial culture and Gram stain. We compared them by age group, dermatomal distribution, duration of the skin lesion, severity of acute pain, and the presence of postherpetic neuralgia and diabetes mellitus. RESULTS: The positive rate of bacterial culture study of the skin lesion was 613% and that of Gram stain was 48.0%. The most common identified pathogen was Staphylococcus epidermidis (83 cases, 35.9%). 61.3% (73/119) of the male patients were positive and 41.9% (108/258) of the female patients were positive in the Gram stain and the difference was significant (p=0.0004). In the relationship with dermatomal distribution, the positive rate in the Gram stain of patients with a distribution of the trigeminal nerve was 62.1% (59/95) and was significantly higher than in other patients (p=0.0276). The positive rate in the bacterial culture of the posthepetic neuralgia group was 71.2% (84/118) and that of the non-postherpetic neuralgia group was 28.8% (34/118). The difference was statistically significant (p=0.008). However the positive rate in the Gram stain of the posthepetic neuralgia group was 55.1% (65/118) and was still higher than that of the non-postherpetic neuralgia group, 44.9% (53/118). But the difference was not statistically significant (p=0.063). 64.4% (38/59) of diabetic patients were positive and 35.6% (21/59) of non-diabetic patients were positive in Gram stain study. The difference was statistically significant (p=0.006). CONCLUSION: The incidence of positive result of the bacterial study in patients with herpes zoster was significantly higher in male patients, patients with a dermatomal distribution of the trigeminal nerve, patients with postherpetic neuralgia, and diabetic patients. But the rate of positive result of the bacterial study was not related to age, duration of the skin lesion, severity of acute pain and postherpetic neuralgia.
