Investigated 52 patients with herpes zoster were treated at Dermatology Derpartment, Army Hospital No 108 showed that: Males is triple than females. Most of patients aged more than 50 years (76.92%). Fever: 9.62%, fatigue:19.23%, swell glands: 53.85%, pain:100% (69.23% of patients who aged more than 50 years had pain). Herpes zoster affected to intercostal space in 38.46%, head-face in 23.07%, lumbar-reproduction-thigh in 19.23%, neck-arm in 11.54% and chist-arm in 3.85%. Mild disease group 3.85%, moderate disease group 26.92% and severe disease group 69.23%. Other conditions seen in patients with herpes zoster included hypertension in 21.62%, stomach disease in 13,46%, diabetes in 11.54%, hyperlipidemia in 9.62%, psoriasis in 3.85% and goutte in 1.92%.
Herpes Zoster ; Therapeutics ; Diagnosis ; Epidemiology ; Outpatients

Herpes zoster (HZ) is the result of reactivation and multiplication of latent varicella zoster virus that persisted in latent form within the sensory ganglia following an earlier attack of varicella. It occurs most frequently in older adults and immunosuppressed individuals. Classically, the rash presents as painful, erythematous, maculopapular, and vesicular lesions that typically involve single dermatome, and usually do not cross the midline. The diagnosis is mainly made clinically, except in patients with atypical manifestations in which laboratory virologic testing is required. HZ has been associated with several complications, of which postherpetic neuralgia is the most common and debilitating. The treatment of HZ includes the use of antiviral agents, analgesics for control of acute zoster pain, good skin care for healing, and prevention of secondary bacterial infection. Antiviral agents should be started within 72 hours of onset to reduce the severity of the infection, the duration of the eruptive phase, and the intensity of acute pain. The options for treating postherpetic neuralgia include lidocaine patch, high dose capsaicin patch, gabapentin, pregabalin, opioids, and tricyclic antidepressants. A live attenuated zoster vaccine reduces the incidence of by one-half and the incidence of postherpetic neuralgia by two-thirds. We herein review the recent data on the epidemiology, pathophysiology, diagnosis and management of HZ including HZ vaccine.
Acute Pain ; Adult ; Analgesics ; Analgesics, Opioid ; Antidepressive Agents, Tricyclic ; Antiviral Agents ; Bacterial Infections ; Capsaicin ; Chickenpox ; Diagnosis ; Epidemiology ; Exanthema ; Ganglia, Sensory ; Herpes Zoster Vaccine ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Incidence ; Lidocaine ; Neuralgia, Postherpetic ; Pregabalin ; Skin Care

General epidemiological data regarding herpes zoster (HZ) are necessary for treatment and prevention of this disease. In addition, epidemiological data can play an important role in evaluating the efficacy and impact of vaccination. Though several epidemiological studies of HZ in Korea have been conducted, they usually depend on hospital-based data and may not be representative of HZ characteristics all over Korea. The purpose of this study was to evaluate the incidence and other epidemiological features of HZ in the general Korean population. We used population-based medical records from the Health Insurance Review & Assessment Service, which includes 50,908,646 medical insurance subscribers, to calculate the incidence of HZ. Also, we analyzed an age-stratified random sample of 1,375,842 individuals to study descriptive epidemiologic characteristics of HZ in Korea in 2011. We observed that the incidence of HZ was 10.4 per 1,000 person-years and was strongly correlated with age. Sex had a major influence on HZ incidence; overall, there were 12.6 cases per 1,000 person years in women and 8.3 cases per 1,000 person years in men. There was no difference in incidence according to the locality and season.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Herpes Zoster/*diagnosis/*epidemiology ; Hospitalization/*statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Seasons ; Sex Distribution ; Young Adult

From the hospital information system (HIS) of 20 national grade III-A general hospitals, 2 960 cases of herpes zoster as the research object, analyzes the relations between the general information, syndrome of traditional Chinese medicine (TCM), western medicine combined diseases, the relationship between the solar term and the incidence of herpes zoster, and the combined use of Chinese and western medicine. Among the patients with 46-65 year old has the highest percentage of diseased; admission to general outpatient clinic is the most; the most common medical payment is medicare; combined disease such as hypertension, diabetes and coronary heart disease is more common; early treatment effect of herpes zoster is better than the sequelae; summer and autumn solar term patients is hospitalized more, TCM syndrome is damp heat of liver fire; about drugs, western medicine is the most commonly used vitamin B1 and mecobalamin, traditional Chinese medicine is the most frequently used Danhong injection, combination therapy with promoting blood circulation drugs and neurotrophic drugs. Thus, herpes zoster, more common in elderly patients, with no obvious relationship between solar term, should be early diagnosis and early treatment, often with combination of Chinese traditional and western medicine treatment.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Herpes Zoster ; diagnosis ; drug therapy ; epidemiology ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Thiamine ; therapeutic use ; Vitamin B 12 ; analogs & derivatives ; therapeutic use ; Young Adult

INTRODUCTIONThe objective of this study was to determine the necessity of further evaluation of patients presented with herpes zoster (HZ) to the Emergency Department for the underlying decreased cell-mediated immunity.

MATERIALS AND METHODSThe data of 132 adult patients presenting with HZ to the Emergency Department were collected from the computerised database of Akdeniz University Hospital. The following data were recorded: demographic data and underlying diseases during onset of HZ and laboratory results (white blood cell counts, blood glucose levels).

RESULTSThere were 132 patients with HZ in the study period. The mean age of patients was 52.98 +/- 18.91 years (range, 14 to 96) and 53% (70 patients) were male. Of the study patients, 70.5% (93 patients) were over 45 years old. Eight (6.1%) patients had been diagnosed to have a malignancy, 18 (13.6%) had diabetes mellitus and 3 (2.3%) patients had undergone organ transplantation during their admission. Malignancy, diabetes mellitus and organ transplantation prevalence in the HZ group was significantly higher than the whole Emergency Department population.

CONCLUSIONSOur results indicate a relationship between the presence of HZ and increasing age and cell-mediated immunosuppressive disorders in Emergency Department patients over the age of 45 years. HZ should be considered as a clinical marker of cell-mediated immunosuppressive disorders, particularly in elderly patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Herpes Zoster ; epidemiology ; etiology ; immunology ; Humans ; Immune Tolerance ; immunology ; Immunity, Cellular ; immunology ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Incidence ; Lymphoproliferative Disorders ; complications ; drug therapy ; immunology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; T-Lymphocyte Subsets ; immunology ; Young Adult

BACKGROUND: The epidemiologic and clinical features of HIV infection/AIDS are different among various races, regions, and countries. To determine the epidemiologic and clinical characteristics of HIV infection in Korea, we analyzed and compared with that of other populations. METHODS: Medical records of 176 HIV-infected persons in Severance Hospital of Yonsei University College of Medicine and Hospital of Pusan University College of Medicine from year 1985 to 2000 were reviewed retrospectively. RESULTS: One hundred and seventy six patients were analyzed among which 156 (88.6%) were male and 20 (11.4%) were female with a male to female ratio of 7.8:1. At the time of diagnosis, the age distribution was 78 cases (44.3%) in the thirties, 44 cases (25.0%) in the twenties, and 35 cases (19.9%) in the fourties, and the mean age was 35.9+/-9.3. Heterosexual contact was the most frequent transmission route (92 cases, 52.3%), and 42 cases (23.9%) were transmitted by homosexual contact. At initial visit, asymptomatic HIV infection constituted 75 cases (42.6%), and AIDS 72 cases (40.9%). At initial visit, mean value of CD4+ lymphocyte counts was 252/mm3 and HIV RNA 226,035 copies/mm3. One hundred and twenty one of 176 patients developed 317 cases of opportunistic diseases. At the diagnosis of HIV-related opportunistic diseases, mean CD4+ lymphocyte count was 140/mm3 and mean HIV RNA 347,403 copies/mm3. Candidiasis (50 cases, 28.4%) was the most frequent opportunistic disease followed by pneumocystis carinii pneumonia (PCP) (37 cases, 21.0%), tuberculosis (29 cases, 16.5%), cytomegalovirus (CMV) infection (21 cases, 11.9%), HIV encephalopathy (9 cases, 5.1%), and herpes zoster (9 cases, 5.1%). There were 3 cases (1.7%) of malignant lymphoma and 2 cases (1.1%) of Kaposi's sarcoma. At the diagnosis of opportunistic diseases, mean CD4+ lymphocyte counts of patients with candidiasis was 71/mm3, PCP 63/mm3, and tuberculosis 142/mm3, and the mean HIV RNA level was 338,474 copies/mm3, 281,967 copies/mm3, and 817,012 copies/mm3 respectively. Among the 317 opportunistic diseases, AIDS-defining diseases were 150 cases (47.3%), of which PCP was 37 cases (24.7%), tuberculosis 29 cases (19.3%), CMV infection 21 cases (14.0%), HIV wasting syndrome 15 cases (10.0%), and esophageal candidiasis 14 cases (9.3%). The earliest AIDS-defining diseases to manifest in AIDS patients were tuberculosis (25 cases, 33.3%), followed by PCP (17 cases, 22.6%), esophageal candidiasis (14 cases, 18.7%), CMV infection (5 cases, 6.6%), and HIV wasting syndrome (4 cases, 5.3%). Thirty five (19.9%) of 176 patients were died. The common causes of death were tuberculosis (9 cases, 25.7%), PCP (9 cases, 25.7%), bacterial pneumonia (7 cases, 20.0%) and HIV encephalopathy (3 cases, 8.5%). CONCLUSION: The epidemiologic and clinical features of HIV infection/AIDS in Korea are different from that of developing countries such as Southeast Asia and Africa as well as from that of developed countries.
Africa ; Age Distribution ; AIDS Dementia Complex ; Asia, Southeastern ; Busan ; Candidiasis ; Cause of Death ; Continental Population Groups ; Cytomegalovirus ; Developed Countries ; Developing Countries ; Diagnosis ; Epidemiology ; Female ; Herpes Zoster ; Heterosexuality ; HIV Infections ; HIV Wasting Syndrome ; HIV* ; Homosexuality ; Humans ; Korea ; Lymphocyte Count ; Lymphoma ; Male ; Medical Records ; Pneumonia, Bacterial ; Pneumonia, Pneumocystis ; Retrospective Studies ; RNA ; Sarcoma, Kaposi ; Tuberculosis