Facial Herpes Zoster: A 15-year Retrospective Single-Center Study
- Author:
Joong Heon SUH
1
;
Soo Kyung LEE
;
Un Ha LEE
;
Myoung Shin KIM
Author Information
1. Department of Dermatology, Inje University Sanggye Paik Hospital, Seoul, Korea. etihwevol@naver.com
- Publication Type:Original Article
- Keywords:
Facial herpes zoster;
Herpes zoster ophthalmicus;
Postherpetic neuralgia;
Ramsay Hunt syndrome
- MeSH:
Ear;
Earache;
Epidemiology;
Facial Paralysis;
Herpes Zoster Ophthalmicus;
Herpes Zoster Oticus;
Herpes Zoster;
Humans;
Incidence;
Medical Records;
Neuralgia, Postherpetic;
Prognosis;
Referral and Consultation;
Retrospective Studies;
Trigeminal Nerve
- From:Korean Journal of Dermatology
2019;57(5):235-242
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Many studies about herpes zoster exist in the Korean dermatologic literature. However, few studies have reported about facial herpes zoster and its complications. OBJECTIVE: The purpose of this study was to investigate the epidemiology, clinical features, and complications of facial herpes zoster. METHODS: We analyzed the medical records of 977 patients who visited Sanggye Paik Hospital between January 2002 and December 2017. We categorized patients into 8 groups based on the dermatomal distribution of herpetic lesions. We investigated the correlations between clinical features, prognosis, and complications. RESULTS: We analyzed the medical records of 977 patients who visited Sanggye Paik Hospital between January 2002 and December 2017. We categorized patients into 8 groups based on the dermatomal distribution of herpetic lesions. We investigated the correlations between clinical features, prognosis, and complications. Results: The most common site of involvement of facial herpes zoster was the ophthalmic branch of the trigeminal nerve (59.2%). Herpes zoster involving the ophthalmic and the maxillary branches of the trigeminal nerves showed a significantly higher incidence rate of herpes zoster ophthalmicus than that observed with herpes zoster involving only the ophthalmic branch (odds ratio 7.373). Age and periorbital swelling were significantly correlated with herpes zoster ophthalmicus (p<0.001). Facial palsy was significantly correlated with otalgia and cutaneous ear involvement (p<0.001). Postherpetic neuralgia (PHN) occurred in 41% of patients with facial herpes zoster. Patients who received antiviral treatment within 3 days showed lower rates of PHN (35.8%) than patients who received treatment after 4 days (45.4%) (p=0.002). CONCLUSION: Facial herpes zoster is associated with several neurological complications. Variables including age, periorbital swelling, otalgia, and cutaneous ear involvement are useful predictors of complications and prognosis. Early institution of antiviral treatment and appropriate interdepartmental consultations are required for better treatment outcomes.
