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Song Y, Yu Z, Guan J, Wu H, Liu Q, Yuan M, Cheng X, Ling B. Efficacy of Gasserian Ganglion High-Voltage, Long-Duration Pulsed Radiofrequency Combined With Block on Acute/Subacute Zoster-Related Trigeminal Neuralgia. Pain Res Manag 2024; 2024:1992483. [PMID: 39346786 PMCID: PMC11427718 DOI: 10.1155/2024/1992483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/24/2024] [Indexed: 10/01/2024]
Abstract
Background: Trigeminal postherpetic neuralgia (TPHN) is a severe chronic pain that can lead to various socioeconomic consequences. Therefore, it is necessary to explore optimal treatment options for acute/subacute herpes zoster (HZ)-related trigeminal neuralgia and prevent the further development of TPHN. High-voltage, long-duration pulsed radiofrequency (HL-PRF) of the Gasserian ganglion is a new surgical intervention used to treat PHN. A ganglion block has been reported to possess anti-inflammatory effects and potential analgesic benefits. Methods: We included 83 patients with HZ-related acute/subacute trigeminal neuralgia admitted from January 1, 2021, to June 1, 2023, and received Gasserian ganglion HL-PRF combined with block. A 6-month follow-up was conducted, including Numerical Rating Scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), the incidence of TPHN, the dosage of anticonvulsants and analgesics, efficacy, and adverse events. Results: All patients showed a significant decrease in postoperative NRS scores (p < 0.05). The NRS scores of the acute HZ group were consistently lower than those of the subacute HZ group at different time points (p < 0.01). The overall incidence of TPHN from the onset of HZ to 12 weeks is 21.68%. The incidence of TPHN in the acute phase group was 12.77%, significantly lower than the 33.33% in the subacute phase group (p=0.024). The effective rate was 74.7% in all patients, at 3 months after the treatment. The effective rate was 82.98% in the acute phase group and 63.89% in the subacute phase group, showing a statistically significant difference (p=0.047). The PSQI score of the acute group was consistently lower than that of the subacute group (p < 0.01). The dosage of analgesics and anticonvulsants used in the acute HZ group was lower than that in the subacute group (p < 0.01). All patients did not experience serious adverse reactions. Conclusions: Gasserian ganglion HL-PRF combined with block can be an effective and safe technique to relieve the pain of acute/subacute zoster-related trigeminal neuralgia and prevent the incidence of TPHN.
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Affiliation(s)
- Yinghao Song
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Ziheng Yu
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Jingjing Guan
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Haisheng Wu
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Qiaoling Liu
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Min Yuan
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xinzhi Cheng
- Department of PainNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Bingyu Ling
- Department of EmergencyNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
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Wang H, Chen G, Gong Q, Wu J, Chen P. Primary immunodeficiency-related genes and varicella-zoster virus reactivation syndrome: a Mendelian randomization study. Front Immunol 2024; 15:1403429. [PMID: 39253091 PMCID: PMC11381235 DOI: 10.3389/fimmu.2024.1403429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 08/08/2024] [Indexed: 09/11/2024] Open
Abstract
Background Currently, evidence regarding the causal relationship between primary immunodeficiency-related genes and varicella-zoster virus reactivation syndrome is limited and inconsistent. Therefore, this study employs Mendelian randomization (MR) methodology to investigate the causal relationship between the two. Methods This study selected 110 single-nucleotide polymorphisms (SNPs) of primary immunodeficiency-related genes as instrumental variables (IVs). Genetic associations of primary immunodeficiency-related genes were derived from recent genome-wide association studies (GWAS) data on human plasma protein levels and circulating immune cells. Data on genes associated with varicella-zoster virus reactivation syndrome were obtained from the GWAS Catalog and FINNGEN database, primarily analyzed using inverse variance weighting (IVW) and sensitivity analysis. Results Through MR analysis, we identified 9 primary immunodeficiency-related genes causally associated with herpes zoster and its subsequent neuralgia; determined causal associations of 20 primary immunodeficiency-related genes with three vascular lesions (stroke, cerebral aneurysm, giant cell arteritis); revealed causal associations of 10 primary immunodeficiency-related genes with two ocular diseases (retinopathy, keratitis); additionally, three primary immunodeficiency-related genes each were associated with encephalitis, cranial nerve palsy, and gastrointestinal infections. Conclusions This study discovers a certain association between primary immunodeficiency-related genes and varicella-zoster virus reactivation syndrome, yet further investigations are warranted to explore the specific mechanisms underlying these connections.
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Affiliation(s)
- Hao Wang
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Guanglei Chen
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Qian Gong
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jing Wu
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Peng Chen
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
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Chen J, Luo C, Ju P, Tu S, Shi S, Wang Z, Wu H. A bibliometric analysis and visualization of acupuncture and moxibustion therapy for herpes zoster and postherpetic neuralgia. Skin Res Technol 2024; 30:e13815. [PMID: 38924142 PMCID: PMC11197023 DOI: 10.1111/srt.13815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To identify major contributors, current research status, and to forecast research trends and future development prospects on acupuncture and moxibustion therapy for herpes zoster (HZ) and postherpetic neuralgia (PHN). METHODS A systematic search was conducted on the China National Knowledge Infrastructure (CNKI), Weipu, WanFang databases, and the Web of Science Core Collection (WoSCC), PubMed, and Scopus databases. The search strategy included relevant terms for HZ, PHN, acupuncture, and moxibustion. The reference type was limited to articles or reviews, with a publication date from January 1, 2014 to December 31, 2023. Data analysis was performed using CiteSpace software, focusing on author, institution, source, and keyword distributions, and temporal trends. RESULTS A total of 1612 publications were identified from both Chinese and English databases. The analysis revealed a rising trend in publication numbers in the English database, with a significant increase observed in 2020. In the Chinese database, publication activity exhibited two peaks in 2019 and 2023. Guohua Lin and Jingchun Zeng were the most prolific authors in the Chinese and English databases, respectively. The Chengdu University of TCM and Zhejiang Chinese Medicine University were the most active institutions. The keyword analysis revealed "herpes zoster" as the most frequent keyword in the Chinese database, while "postherpetic neuralgia," "acupuncture," and "management" were prominent in the English database. The study also identified several therapeutic approaches, including fire needle therapy and electroacupuncture, which have shown efficacy in treating HZ and PHN. Animal studies provided insights into the mechanisms of these therapies, suggesting potential modulation of neuroinflammatory markers and intracellular signaling pathways. CONCLUSION The bibliometric analysis underscores the growing interest in acupuncture and moxibustion therapy for HZ and PHN. It highlights the contributions of key authors and institutions while pinpointing potential areas for future research. The study advocates for the necessity of large-scale, multi-center clinical trials and further basic mechanical research to optimize these therapies. Moreover, it also emphasizes the importance of international collaboration to strengthen the evidence base and expand the global impact of this traditional treatment modality.
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Affiliation(s)
- Jianhua Chen
- Yueyang Hospital of Integrated Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
- Shanghai Research Institute of Acupuncture and MeridianKey Laboratory of Acupuncture and Immunological EffectsShanghai University of Traditional Chinese MedicineShanghaiChina
- Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai Institute of Traditional Chinese Medicine for Mental HealthShanghai Clinical Research Center for Mental HealthShanghai Key Laboratory of Psychotic DisordersShanghaiChina
- Brain Health Institute at National Center for Mental DisorderShanghaiChina
- Department of Psychiatrythe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Chao Luo
- Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai Institute of Traditional Chinese Medicine for Mental HealthShanghai Clinical Research Center for Mental HealthShanghai Key Laboratory of Psychotic DisordersShanghaiChina
- Brain Health Institute at National Center for Mental DisorderShanghaiChina
| | - Peijun Ju
- Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai Institute of Traditional Chinese Medicine for Mental HealthShanghai Clinical Research Center for Mental HealthShanghai Key Laboratory of Psychotic DisordersShanghaiChina
- Brain Health Institute at National Center for Mental DisorderShanghaiChina
| | - Sijing Tu
- School of Public HealthHangzhou Normal UniversityHangzhouChina
- School of Public Health and ManagementGuangxi University of Chinese MedicineNanningChina
| | - Si Shi
- Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai Institute of Traditional Chinese Medicine for Mental HealthShanghai Clinical Research Center for Mental HealthShanghai Key Laboratory of Psychotic DisordersShanghaiChina
- Brain Health Institute at National Center for Mental DisorderShanghaiChina
| | - Zhaoqin Wang
- Yueyang Hospital of Integrated Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
- Shanghai Research Institute of Acupuncture and MeridianKey Laboratory of Acupuncture and Immunological EffectsShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Huangan Wu
- Yueyang Hospital of Integrated Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
- Shanghai Research Institute of Acupuncture and MeridianKey Laboratory of Acupuncture and Immunological EffectsShanghai University of Traditional Chinese MedicineShanghaiChina
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Domínguez-Casas LC, Lasa-Teja C, Ferraz-Amaro I, Castañeda S, Blanco R. Increased Risk of Herpes Zoster in Rheumatoid Arthritis Not Only Due to JAK Inhibitors-Study of 392 Patients from Single University Center. J Clin Med 2024; 13:3121. [PMID: 38892832 PMCID: PMC11172981 DOI: 10.3390/jcm13113121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/08/2024] [Accepted: 05/07/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Patients with rheumatoid arthritis (RA) have an increased risk of infection. Their risk of presenting herpes zoster (HZ) is 1.5-2 times higher than immunocompetent individuals and disseminated presentation is more frequent. Our aim was to analyze the prevalence and general features of HZ in RA patients. Methods: This was a prospective study of 392 RA patients included in the vaccination program of our hospital between 2011 and 2016, and follow-up continued until December 2020. A diagnosis of HZ was made according to clinical manifestations: skin rash, blisters, paresthesia, and local pain in one or more dermatomes. Results: We studied 392 participants (309 women/83 men), mean age 59 ± 13 years. Every patient was followed-up over a mean period of 137 ± 110 months (range: 42 months-42 years). HZ infection was observed in 30 of 392 (25 women/5 men) patients, age (mean ± SD) 64.7 ± 11.8 years. Prevalence was 7.65% in this period and the incidence rate was 13.22/1000 patients/year. Three patients had facial involvement, one had optic involvement, and one patient presented disseminated HZ. Seven patients presented post herpetic neuralgia treated with gabapentinoids. The main features of RA of these 30 patients were: positive RF (n = 17; 56.6%), positive anti-CCP (n = 13; 43.3%), and erosive disease (n = 10; 33.3%). At HZ infection, the treatments were glucocorticoids (n = 19; 63.3%), conventional DMARDs (n = 15; 50%), biological DMARDs (n = 15; 50%), tofacitinib (n = 2; 6.6%), and upadacitinib (n = 1; 3.3%). Conclusions: HZ is a relatively frequent viral complication in RA patients. In our series, one patient presented disseminated HZ and nearly 25% of patients had post-herpetic neuralgia. Including a HZ vaccine in our vaccination program for RA patients may be beneficial.
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Affiliation(s)
| | - Carmen Lasa-Teja
- Rheumatology, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Iván Ferraz-Amaro
- Rheumatology, Hospital Universitario de Canarias, 38320 Tenerife, Spain;
| | - Santos Castañeda
- Rheumatology, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain;
| | - Ricardo Blanco
- Rheumatology, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
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Yogi TN, Bhusal A, Subedi S, Katwal S, Acharya K. Multidermatomal herpes zoster triggered by psychological stress in an immunocompetent young adult: a rare case report and clinical insights. Ann Med Surg (Lond) 2023; 85:6231-6236. [PMID: 38098591 PMCID: PMC10718367 DOI: 10.1097/ms9.0000000000001409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction and Importance Herpes zoster (HZ), a reactivated varicella zoster virus infection arising from dormant viral latency after initial chickenpox, manifests as localized skin rashes along dermatomes. Multidermatomal involvement, especially in immunocompetent individuals, is rare. The potential link between psychological stress and HZ reactivation remains underexplored. The authors present a case of multidermatomal HZ triggered by psychological stress in a young immunocompetent adult. Case presentation A 26-year-old male presented with vesicular lesions spanning C5, C8, T1, and T2 dermatomes, triggered by psychological stress. The disease exhibited a unique midline-crossing presentation. The Varicella zoster virus IgM test result was positive. Treatment included acyclovir, pain management, and stress reduction strategies, yielding complete resolution within 3 weeks. Clinical discussions The case highlights a distinctive multidermatomal HZ presentation, defying conventional dermatomal restrictions. Psychological stress potentially influenced viral reactivation. Immunocompetence and stress interplay merit further exploration. Multidermatomal HZ necessitates prompt clinical recognition and comprehensive evaluation. Antiviral therapy and integrated stress management may contribute to successful outcomes. Conclusion This case underscores the rare occurrence of multidermatomal HZ in an immunocompetent young adult triggered by psychological stress. The atypical presentation and potential role of stress in viral reactivation emphasize the complex interaction between the nervous and immune systems. Integrated clinical management, stress reduction strategies, and antiviral therapy were effective in resolving the condition. Further research is warranted to elucidate the mechanisms underlying stress-induced viral reactivation and its clinical implications.
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Affiliation(s)
| | - Amrit Bhusal
- Department of Dermatology and Venerology, BP Koirala Institute of Health Sciences (BPKIHS)
| | - Suman Subedi
- Department of Dermatology and Venerology, BP Koirala Institute of Health Sciences (BPKIHS)
| | | | - Kshitiz Acharya
- Department of Dermatology and Venereology, Tribhuvan University Institute of Medicine
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Zhang N, Chen Y, Li C, Qin X, He D, Wei W, Zhao Y, Cai Q, Shi S, Chu X, Wen Y, Jia Y, Zhang F. A systematical association analysis of 25 common virus infection and genetic susceptibility of COVID-19 infection. Microbes Infect 2023; 25:105170. [PMID: 37315735 PMCID: PMC10259091 DOI: 10.1016/j.micinf.2023.105170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Previous studies identified a number of diseases were associated with 2019 coronavirus disease (COVID-19). However, the associations between these diseases related viral infections and COVID-19 remains unknown now. METHODS In this study, we utilized single nucleotide polymorphisms (SNPs) related to COVID-19 from genome-wide association study (GWAS) and individual-level genotype data from the UK biobank to calculate polygenic risk scores (PRS) of 487,409 subjects for eight COVID-19 clinical phenotypes. Then, multiple logistic regression models were established to assess the correlation between serological measurements (positive/negative) of 25 viruses and the PRS of eight COVID-19 clinical phenotypes. And we performed stratified analyses by age and gender. RESULTS In whole population, we identified 12 viruses associated with the PRS of COVID-19 clinical phenotypes, such as VZV seropositivity for Varicella Zoster Virus (Unscreened/Exposed_Negative: β = 0.1361, P = 0.0142; Hospitalized/Unscreened: β = 0.1167, P = 0.0385) and MCV seropositivity for Merkel Cell Polyomavirus (Unscreened/Exposed_Negative: β = -0.0614, P = 0.0478). After age stratification, we identified seven viruses associated with the PRS of eight COVID-19 clinical phenotypes in the age < 65 years group. After gender stratification, we identified five viruses associated with the PRS of eight COVID-19 clinical phenotypes in the women group. CONCLUSION Our study findings suggest that the genetic susceptibility to different COVID-19 clinical phenotypes is associated with the infection status of various common viruses.
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Affiliation(s)
- Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyue Qin
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Dan He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yijing Zhao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Qingqing Cai
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Sirong Shi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoge Chu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Fan HR, Zhang EM, Fei Y, Huang B, Yao M. Early Diagnosis of Herpes Zoster Neuralgia: A Narrative Review. Pain Ther 2023; 12:893-901. [PMID: 37129752 PMCID: PMC10289968 DOI: 10.1007/s40122-023-00510-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/30/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Early intervention reduces the incidence of postherpetic neuralgia (PHN). Typical shingles are easy to diagnose; however, there is no clear diagnostic method for neuralgia symptoms manifested before the onset of the rash, which can easily cause misdiagnosis. This not only increases the patient's pain, medical expenses, and mental burden, but more importantly, delays the valuable time for early treatment of shingles, and increases the probability of complications and PHN. OBJECTIVE In this paper, the diagnostic methods of preherpetic neuralgia were summarized and analyzed, and the current challenges were put forward to provide directions for the early diagnosis of herpes zoster (HZ) in the future. METHODS PubMed, and China National Knowledge Infrastructure (CNKI) libraries were searched using the terms "herpes zoster," "before the blistering," "diagnosis," and "neuralgia." Clinical trials, reviews, and case reports were collected and reviewed. The period of literature search is from 1 January 1980 to 1 October 2022. RESULTS The early diagnosis of herpes zoster neuralgia can reduce misdiagnosis and mistreatment, and timely and effective intervention can significantly reduce the incidence of PHN. The body may possess a mechanism that limits the local breakthrough of the virus in the skin, causing blistering later than the onset of pain. Changes in the plasma proteins of patients with varicella-zoster virus shingles neuralgia may be used as an early diagnostic indicator in patients with HZ neuralgia before eruption. CONCLUSION Early diagnosis of HZ neuralgia before eruption can facilitate timely targeted treatment, thereby reducing the incidence of PHN. Proteomic quantitative analysis and validation results can serve as a simple, micro, rapid, and accurate diagnostic method.
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Affiliation(s)
- Han-Rui Fan
- Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - En-Ming Zhang
- Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Yong Fei
- Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, 1882 Zhong-Huan-South Road, Jiaxing, 314000, People's Republic of China.
| | - Bing Huang
- Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, 1882 Zhong-Huan-South Road, Jiaxing, 314000, People's Republic of China
| | - Ming Yao
- Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, 1882 Zhong-Huan-South Road, Jiaxing, 314000, People's Republic of China
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Bazzacco G, Conforti C, Toffoli L, Zelin E, Zalaudek I, di Meo N. Dermoscopic Features of Herpes Zoster: Case Series and Review of the Literature. Dermatol Pract Concept 2023; 13:e2023149. [PMID: 37557161 PMCID: PMC10412062 DOI: 10.5826/dpc.1303a149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Giulia Bazzacco
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Ludovica Toffoli
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Enrico Zelin
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Nicola di Meo
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
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Chen W, Zhu L, Shen LL, Si SY, Liu JL. T Lymphocyte Subsets Profile and Toll-Like Receptors Responses in Patients with Herpes Zoster. J Pain Res 2023; 16:1581-1594. [PMID: 37220634 PMCID: PMC10200109 DOI: 10.2147/jpr.s405157] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose Herpes zoster (HZ) is caused by the varicella-zoster virus (VZV), and 20% of healthy humans and 50% of people with immune dysfunction have a high probability of suffering from HZ. This study aimed to screen dynamic immune signatures and explore the potential mechanism during HZ progression. Patients and Methods Peripheral blood samples from 31 HZ patients and 32 age-sex-matched healthy controls were collected and analyzed. The protein levels and gene levels of toll-like receptors (TLRs) were detected in peripheral blood mononuclear cells (PBMCs) by flow cytometry and quantitative real-time PCR. Further, the characteristics of T cell subsets and cytokines were detected via a cytometric bead array. Results Compared to healthy controls, the mRNA levels of TLR2, TLR4, TLR7, and TLR9 mRNA in PBMCs were significantly increased in HZ patients. The protein level of TLR4 and TLR7 was significantly increased in HZ patients, but the levels of TLR2 and TLR9 were dramatically decreased. The CD3+ T cells were constant in HZ and healthy controls. CD4+ T cells were decreased in HZ patients, while CD8+ T cells were increased, resulting in an improved CD4+/CD8+ T cells ratio. Further, it was found that Th2 and Th17 were not changed, but the decreased Th1 and upregulated Treg cells were found in HZ. The Th1/Th2 and Th17/Treg ratios were significantly decreased. Last, the levels of IL-6, IL-10, and IFN-γ were significantly increased, but IL-2, IL-4, and IL-17A had no significant changes. Conclusion The dysfunction of host's lymphocytes and activation of TLRs in PBMCs were the important mechanism in varicella-zoster virus induced herpes zoster. TLRs might be the core targets for the therapy drug development in treating HZ.
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Affiliation(s)
- Wei Chen
- Dermatology, Zhejiang Provincial Dermatology Hospital, Huzhou, Zhejiang, People’s Republic of China
| | - Lu Zhu
- Dermatology, Zhejiang Provincial Dermatology Hospital, Huzhou, Zhejiang, People’s Republic of China
| | - Li-Ling Shen
- Dermatology, Zhejiang Provincial Dermatology Hospital, Huzhou, Zhejiang, People’s Republic of China
| | - Shao-Yan Si
- Department of Comprehensive Basic Experiment, Strategic Support Force Medical Center, Bejing, People’s Republic of China
| | - Jun-Lian Liu
- Dermatology, Chui Yang Liu Hospital Affiliated Tsinghua University, Beijing, People’s Republic of China
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10
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Xu G, Xu S, Gong W, Dong S, Yu H. Low Trend for VZV-Associated Disease Patients to Visit Neurologists. J Multidiscip Healthc 2023; 16:1379-1392. [PMID: 37215749 PMCID: PMC10199679 DOI: 10.2147/jmdh.s412398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
Background Herpes zoster (HZ) is a skin disease that can also cause virus-infectious peripheral neuropathies. Despite this, there is limited information on patient preferences for seeking medical attention for HZ and zoster-associated pain (ZAP). Our study aimed to evaluate how frequently patients with ZAP choose to visit neurologists for their symptoms. Methods This study conducted a retrospective review of electronic health records in three general hospitals from January 2017 to June 2022. Using association rule mining, the study analyzed referral behaviors. Results We identified 33,633 patients with 111,488 outpatient visits over 5.5 years. The study found that the majority of patients (74.77-91.22%) visited dermatologists during their first outpatient visit, while only a small percentage (0.86-1.47%) preferred to consult a neurologist. The proportion of patients referred to a specialist during their medical visit varied significantly between different specialties within the same hospital (p <0.05) and even within the same specialty (p<0.05). There was a weak association (Lift:1.00-1.17) of referral behaviors between dermatology and neurology. Across the three hospitals, the average number of visits to a neurologist for ZAP was 1.42-2.49, with an average electronic health record duration of 11-15 days per patient. After consulting with a neurologist, some patients were referred to other specialists. Conclusion It was observed that patients with HZ and ZAP tended to visit a variety of specialists, with only a small number seeking the assistance of neurologists. However, from the perspective of neuroprotection, it is the duty of neurologists to provide more means.
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Affiliation(s)
- Gang Xu
- Department of Rehabilitation Medicine, Affiliated Tenth People’s Hospital of Tongji University, Shanghai Tenth People’s Hospital, Shanghai, 20072, People’s Republic of China
- Department of Rehabilitation Medicine, Tongji University School of Medicine, Shanghai, 200092, People’s Republic of China
| | - Site Xu
- Division of Information and Statistics, Affiliated Ruijin Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Weiwei Gong
- Department of Rehabilitation Medicine, Tongji University School of Medicine, Shanghai, 200092, People’s Republic of China
- Department of Rehabilitation Medicine, Shanghai First Rehabilitation Hospital, Shanghai, 200090, People’s Republic of China
| | - Shihong Dong
- Department of Rehabilitation Medicine, Tongji University School of Medicine, Shanghai, 200092, People’s Republic of China
| | - Hecheng Yu
- Department of Rehabilitation Medicine, Affiliated Tenth People’s Hospital of Tongji University, Shanghai Tenth People’s Hospital, Shanghai, 20072, People’s Republic of China
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11
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Son HJ, Choi EJ, Jeong U, Choi YJ. Effect of Herpes Zoster Treatment and Sudden Sensorineural Hearing Loss Using National Health Insurance Claims Data of South Korea. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040808. [PMID: 37109766 PMCID: PMC10143438 DOI: 10.3390/medicina59040808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/08/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
Background and objectives: Herpes zoster (HZ) is caused by the reactivation of a pre-existing latent varicella zoster virus, which is one of the viruses that causes hearing loss, and hearing loss may occur due to a systemic immune response even if it does not invade the auditory nerve. This study aimed to determine the correlation between sudden sensorineural hearing loss (SSNHL) in older adult patients who received HZ treatment. Materials and Methods: We used the cohort data of patients aged 60 years and above (n = 624,646) between 2002 and 2015 provided by the National Health Insurance Service. The patients were divided into two groups: those who were diagnosed with HZ between 2003 and 2008 (group H, n = 36,121) and those who had not been diagnosed with HZ between 2002 and 2015 (group C, n = 584,329). Results: In the main model (adjusted HR = 0.890, 95% CI = 0.839-0.944, p < 0.001) adjusted for sex, age, and income, and the full model (adjusted HR = 0.894, 95% CI = 0.843-0.949, p < 0.001) adjusted for all comorbidities, group H had a lower risk of SSNHL than group C. Conclusions: This study showed that patients who received HZ treatment had a lower incidence of SSNHL within five years after diagnosis.
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Affiliation(s)
- Hyo Jung Son
- Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul 05715, Republic of Korea
| | - Eun-Ji Choi
- Department of Dental Anesthesia and Pain Medicine, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Ukjin Jeong
- Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul 05715, Republic of Korea
| | - Yoon Ji Choi
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
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12
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Wang C, Dou Z, Yan M, Wang B. Efficacy and Safety of Pulsed Radiofrequency in Herpes Zoster Related Trigeminal Neuralgia: A Systematic Review and Meta-Analysis. J Pain Res 2023; 16:341-355. [PMID: 36756203 PMCID: PMC9901482 DOI: 10.2147/jpr.s396209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose Pulsed radiofrequency (PRF) is a neuromodulation technique for neuropathic pain. However, the effects of PRF on zoster-related trigeminal neuralgia (TN) remain unclear. The purpose of this meta-analysis is to investigate the efficacy and safety of PRF in the management of zoster-related TN. Patients and Methods We searched PubMed, Embase, Cochrane Library, Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wanfang for randomized controlled trials from their inception to August 2022. The primary clinical outcomes included pain intensity and adverse events. Secondary clinical outcomes included pain remission rate, trigeminal postherpetic neuralgia (TPHN) incidence, rescue analgesic dose, sleep quality, and quality of life (QoL). Results Eight studies with 788 participants were included for final analysis. PRF group exhibited lower pain scores (week 1: MD -2.10, 95% CI -3.28 to -0.93, P=0.0005; week 4: MD -1.56, 95% CI -2.60 to -0.51, P=0.003; week 12: MD -1.52, 95% CI -2.68 to -0.35, P=0.01), lower risk of TPHN incidence (RR 0.22, 95% CI 0.06 to 0.81, P=0.02) and better sleep quality (week 4: MD -2.52, 95% CI -3.28 to -1.77, P<0.01; week 12: MD -2.25, 95% CI -2.90 to -1.60, P<0.01) than control group. Besides, pain remission rate (RR 1.08, 95% CI 0.93 to 1.26, P=0.31) and adverse events (RR 0.95, 95% CI 0.71 to 1.27, P=0.74) were comparable in both groups. Conclusion PRF is an effective and safe treatment and it yields better effects in pain relief, improvement of sleep quality, and prevention of developing TPHN. Although PRF provides a comparable pain remission rate with the control, it is still a preferred and alternative treatment for relieving zoster-related facial pain.
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Affiliation(s)
- Chenhui Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhi Dou
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Mengwei Yan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Baoguo Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, People’s Republic of China,Correspondence: Baoguo Wang, Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Street, Haidian District, Beijing, 100095, People’s Republic of China, Tel/Fax +86 10 6285 6766, Email
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13
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Dlamini ST, Htet KM, Theint ECC, Mayadilanuari AM, Li WM, Tung YC, Tu HP. Herpes Zoster Risk in Patients with Rheumatoid Arthritis and Its Association with Medications Used. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2123. [PMID: 36767490 PMCID: PMC9915285 DOI: 10.3390/ijerph20032123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Rheumatoid arthritis (RA) was associated with the risk of incident herpes zoster (HZ), which might be influenced by medication use by RA patients. We aimed to investigate the association of RA with the risk of incident HZ and how the HZ risk effected by RA medications in CIC RA patients. We conducted an observational study including population-based representative insurance claims data of 19,673 patients with RA and 39,346 matched patients without RA during 1997-2010 from the Taiwan National Health Insurance Research Database; we identified 1651 patients with catastrophic illness-certified (CIC) RA and 11,557 matched patients with non-CIC RA. Exploratory analyses assessed the association between RA/CIC RA and risk of incident HZ and its complications. The association of prescribed medications with HZ risk in CIC RA patients was also estimated. The incidence rates of HZ were higher in CIC RA patients and non-CIC RA than in the matched people without RA (21.95 and 14.03 vs. 7.36 events per 1000 person-years, respectively). The adjusted incidence rate ratio (95% confidence interval (CI)) for HZ was 1.74 (1.65-1.84) in RA patients vs. matched non-RA and 1.65 (1.44-1.89) in CIC RA patients vs. non-CIC RA. For HZ complications, RA had a 2.85-fold higher risk than non-RA, and CIC RA had a 1.78-fold higher risk than non-CIC RA. Moreover, in CIC RA patients, prednisolone use was associated with incident HZ risk compared with prednisolone nonuse (adjusted odds ratio 1.48, 1.08-2.03); prolonged prednisolone use (approximately 5 years) increased the risk (adjusted odds ratio 2.16, 1.46-3.19). Our results suggested that RA was positively associated with HZ risk, particularly in RA patients with prednisolone use.
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Affiliation(s)
| | - Kyaw Moe Htet
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Ei Chue Chue Theint
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | | | - Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Urology, Ministry of Health and Welfare, Pingtung Hospital, Pingtung 90054, Taiwan
| | - Yi-Ching Tung
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
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14
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Ma Y, Tian Y, Chen X, Agrawal R, Feng Y. Bilateral Pupillary Involvement as a Clinical Presentation of Herpes Zoster Ophthalmicus. Ocul Immunol Inflamm 2023; 31:87-91. [PMID: 34637674 DOI: 10.1080/09273948.2021.1986075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE Herpes zoster ophthalmicus (HZO) is traditionally considered as an unilateral disease. However, subclinical involvements in the contralateral eye structures are evidence, giving rise to a broader understanding of varicella-zoster virus (VZV) infection. METHODS We enrolled 20 eyes of 10 patients with HZO and 12 eyes of healthy controls to investigate the bilateral features of HZO patients using a hand-held pupillometer and a Cochet-Bonnet esthesiometer. RESULTS Maximum pupil size before constriction (INT) and minimum diameter when pupil constricts at peak (END) were significantly smaller in patients affected eyes compared with those in controls (p < .05). Interestingly, INT and END were significantly reduced in contralateral eyes of 20 affected patients and also in comparison to control group (p < .001 and p = .034 respectively). CONCLUSION The contralateral eyes may have subclinical involvement in patients with HZO based on significantly abnormal pupillary light reflex (PLR). Pupillometer provides a primary and convenient method to investigate the anatomy and pathology of the PLR.
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Affiliation(s)
- Yan Ma
- Department of Neurology, Peking University Third Hospital, Bejing, China
| | | | - Xia Chen
- Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing, China
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital; Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Bejing, China
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15
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Lin QX, Meng HJ, Pang YY, Qu Y. Recurrent herpes zoster in a rheumatoid arthritis patient treated with tofacitinib: A case report and review of the literature. World J Clin Cases 2022; 10:8703-8708. [PMID: 36157812 PMCID: PMC9453357 DOI: 10.12998/wjcc.v10.i24.8703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/16/2022] [Accepted: 07/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Tofacitinib is an oral Janus kinase (JAK) inhibitor that is currently approved by the United States Food and Drug Administration for the treatment of rheumatoid arthritis (RA). Varicella zoster virus reactivation leading to herpes zoster (HZ) is an adverse effect of this drug; however, recurrent HZ at the same site is a rare clinical condition.
CASE SUMMARY A 70-year-old female RA patient had undergone 1-year of tofacitinib treatment (10 mg daily). About 1 mo after initiation of oral tofacitinib, she developed blisters on the left flank and abdomen and was diagnosed with HZ; antiviral therapy with acyclovir was resolutory. However, 5 d prior to presentation at our hospital, erythema and blisters with severe pain recurred at the same site. Small clustered blisters and bullous were visible on the left lumbar abdomen and perineum, with a pain score of 8 (visual analogue scale). Antiviral, nutritional supplement, analgesic and other treatments led to healing but over an atypically long period (approximately 26 d, vs approximately 1 wk). HZ is a common and serious adverse reaction of JAK inhibitors, but it rarely recurs. Our patient’s experience of HZ recurrence at the same site, with a wider affected area, more severe pain and longer healing period, is inconsistent with previous reports.
CONCLUSION Same-anatomical site HZ recurrence may occur during oral tofacitinib treatment, with more severe clinical manifestations than in the initial occurrence.
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Affiliation(s)
- Qing-Xia Lin
- Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
| | - Hui-Juan Meng
- Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
| | - Yun-Yan Pang
- Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
| | - Yan Qu
- Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
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16
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Howell M, Loera S, Kirkland-Kyhn H. Cutaneous Anomalies of the Critically Ill Patient. AACN Adv Crit Care 2022; 33:165-172. [PMID: 35657760 DOI: 10.4037/aacnacc2022402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Critically ill patients are at high risk for organ failure, including that of the integumentary system. Nurses working in intensive care are adept at performing comprehensive assessments that include the skin. Although pressure injury is a well-known complication associated with critical illness, patients may also have debilitating and life-threatening dermatoses. Conditions such as skin failure and medical adhesive-related skin damage are commonly seen in the critically ill. Infectious processes, such as Fournier gangrene, invasive candidiasis, mucormycosis, and herpetic lesions, can result in severe or superimposed critical illness and elude detection. Similarly, cutaneous manifestations of COVID-19 may develop prior to commonly recognized symptoms of infection. Nurses and providers caring for critically ill patients should be aware of common, but less widely known, skin conditions to facilitate early detection and treatment.
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Affiliation(s)
- Melania Howell
- Melania Howell is Wound Ostomy Continence Specialist, Emanuel Medical Center, 825 Delbon Avenue, Turlock, CA 95382
| | - Salomé Loera
- Salomé Loera is Clinical Nurse Specialist, Adult Critical Care Services, Inova Fairfax Medical Campus, Falls Church, Virginia
| | - Holly Kirkland-Kyhn
- Holly Kirkland-Kyhn is Director of Wound Care, University of California, Davis Medical Center, Sacramento, California
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17
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Yu T, Song J, Chen X, Li J, Yang S, Yang J. Herpes Zoster Duplex Bilateralis After Trauma Induced Emotional Dysregulation: A Case Report and Literature Review. Infect Drug Resist 2022; 15:2657-2660. [PMID: 35637929 PMCID: PMC9148264 DOI: 10.2147/idr.s364156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Herpes zoster (HZ) is usually distributed on one side of the body; HZ duplex bilateralis is very rare with only 0.1% of all HZ cases. The occurrence of HZ duplex bilateralis is associated with abnormal immune function. In this report, we present a case of a 47-year-old woman who had no major health issues developed HZ duplex bilateralis after an adverse life event and extreme depression one month ago. HZ related symptoms were controlled after patient received antiviral, analgesic, and nerve-nourishing treatment in our hospital.
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Affiliation(s)
- Tianhang Yu
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, People’s Republic of China
| | - Jikai Song
- Zhejiang Provincial People’s Hospital, Qingdao University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Xin Chen
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, People’s Republic of China
| | - Jin Li
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, People’s Republic of China
| | - Shuang Yang
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, People’s Republic of China
| | - Jie Yang
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, People’s Republic of China
- Correspondence: Jie Yang, Tel +8618832506999, Email
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18
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Almutairi N, Almutairi AN, Almazyad M, Alwazzan S. Herpes Zoster in the era of COVID 19: A prospective observational study to probe the association of herpes zoster with COVID 19 infection and vaccination. Dermatol Ther 2022; 35:e15521. [PMID: 35434963 PMCID: PMC9111648 DOI: 10.1111/dth.15521] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/12/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Herpes zoster (HZ) is caused by reactivation of the latent varicella zoster virus (VZV) following decline in cell-mediated immunity. All over the world, in the past couple of years, the Corona Virus 2019 (COVID-19) has emerged as a viral cause of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection. Based on the current limited evidence, co-infection of COVID-19 with varicella zoster virus or reactivation of VZV after COVID-19 vaccination has been sporadically reported. METHODS All patients diagnosed with HZ, in Farwaniya Hospital in Kuwait, from March 2020 to July, 2021, having either (A) a positive COVID-19 Polymerase Chain Reaction (PCR) test or (B) been vaccinated against SARS-CoV-2 were enrolled in the study. All patients' demographic information, medical history, laboratory findings, and vaccination status was documented. All statistical analyses were performed using SPSS Statistics version 21.0 software. RESULTS Twelve cases infected with COVID-19 with a positive PCR (group 1) and five cases vaccinated against SARS-CoV-2 (group 2) were documented. Out of the twelve COVID-19 infected patients (group 1), only two patients (16.67%) required hospitalization, while the remaining ten patients had mild/moderate lymphopenia. Furthermore, among the twelve positive COVID-19 cases, four patients with HZ were diagnosed within the first week of COVID-19, while the remaining eight cases were diagnosed within eight weeks of COVID-19. Thoracic segments were affected in five cases (41.67%), cervical in one case (8.33%), cranial in two cases (16.67), lumbar in three cases (25.00%) and sacral in one case (8.33%). In group 2, three patients presented with HZ within four weeks of having received the first dose of the vaccine and two patients after the second dose. Blood investigations for all five vaccinated patients did not show any abnormalities. Cervical segments were affected in two patients (40%), and cranial, thoracic and lumbar segment in the remaining patients respectively (20%). CONCLUSIONS Experts must be aware of the probable increased risk of HZ during the Covid 19 pandemic. We propose appropriate curative and preventive measures against herpes zoster infection, including a systematic follow-up of these patients to ensure that they stick to extreme safety measures till the diagnosis of COVID-19 is omitted This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Nawaf Almutairi
- Department of Medicine, Faculty of Medicine, Kuwait University
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19
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Li Y, Tong L, Quek C, Feng Y. The Role of Nervous System and Immune System in Herpes Zoster Ophthalmicus Dissemination and Laterality - Current Views. Ocul Immunol Inflamm 2022; 31:810-818. [PMID: 35412940 DOI: 10.1080/09273948.2022.2058556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Herpes zoster ophthalmicus (HZO) is a sight-threatening condition that is defined as HZ involving the ophthalmic division of the trigeminal nerve. Cases of bilateral HZO in recent literature question the notion of HZO being a strictly unilateral disease. Its pathogenesis is a topic of debate and current literature on VZV dissemination lacks insight into the underlying immunology. This review focuses on novel research in immunology of HZO and aims to formulate hypotheses of spread of lesions through the CNS. METHODS A literature search was conducted on Entrez PubMed using the search terms "bilateral" and "herpes zoster ophthalmicus". Articles on ("Immunology" or "immune cells") and "herpes zoster ophthalmicus" were also searched for. Articles published from January 1942 to April 2020 that were in English language were included. RESULTS Our findings revealed that hypothesised mechanisms of dissemination causing bilateral ocular disease include transmission from nerves to vessel walls, the synergistic action of the immune and nervous systems through the action of substance P and the von Szily reaction. CONCLUSIONS These mechanisms may be investigated using newer models of animal experimentation. It is imperative to define the molecular mechanisms behind VZV transmission to improve methods of identification, treatment, and prevention of HZO.
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Affiliation(s)
- Yue Li
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, Haidian, China
| | - Louis Tong
- Cornea and External Eye Disease Service, Singapore National Eye Centre, Singapore, Singapore.,Ocular Surface Research Group, Singapore Eye Research Institute, Singapore, Singapore.,Clinical Program, Duke-National University of Singapore Medical School, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chrystie Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yun Feng
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, Haidian, China
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20
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ATSÜ AN, ORUC ADALI G, CAF N, TÜRKOGLU Z. Evaluation of Demographic and Clinical Data of Herpes Zoster Patients Admitted To Tertiary Referral Dermatology Clinic During COVID-19 Pandemic. DICLE MEDICAL JOURNAL 2022. [DOI: 10.5798/dicletip.1086294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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External Therapy of Chinese Medicine for Herpes Zoster: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3487579. [PMID: 35310025 PMCID: PMC8930213 DOI: 10.1155/2022/3487579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
Abstract
Background. Herpes zoster (HZ) is a common skin disease that has a huge impact on the quality of life of sufferers. Antiviral therapy is a conventional treatment, but it still has limitations. This review evaluates the safety and efficacy of acupuncture in the treatment of HZ. Methods. We identified randomized controlled trials from multiple electronic sources (including Embase, PubMed, Cochrane, Web of Knowledge, China National Knowledge Infrastructure (CNKI), and China Biology Medicine Disc (CBM)) and reference lists of relevant articles and extracted data and assessed risk of bias (Cochrane’s Risk of Bias tool). Pooled data are expressed as standardized mean differences (SMDs), with 95% confidence intervals (CI) (random-effects model). Results. We included 15 trials (1811 participants) comparing acupuncture to medicine. Ten studies involving 1424 patients provided these data for the meta-analysis. The results showed that acupuncture as a control group had a higher clinical cure rate than Western medicine therapy (n = 1424, 95% Cl 2.19–3.14, I2 = 0%). Eleven studies used the visual analog scale (VAS), but only nine provided specific data, which we used as a continuous variable for data extraction. The meta-analysis also showed an SMD of −2.64 (n = 646, 95% CI −3.79–1.48, I2 = 97%) which showed great heterogeneity. Meta-analysis showed a significant reduction in the incidence of PHN in those who received acupuncture compared to pharmacotherapy (OR = 0.35, 95% CI 0.04–2.86, I2 = 52%) which showed moderate heterogeneity. Economic indicators suggest that acupuncture costs less and has fewer adverse reactions. Conclusions. This review compares acupuncture therapy with conventional treatment and finds that the curative effects of acupuncture are exact, with fewer side effects. However, with the risk of bias and imprecision of the studies included, a concrete conclusion is difficult to draw. Thus, well-designed, rigorous studies are warranted in the future.
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22
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Rahangdale RR, Tender T, Balireddy S, Pasupuleti M, Hariharapura RC. The Interplay Between Stress and Immunity Triggers Herpes Zoster Infection in COVID-19 Patients: A Review. Can J Microbiol 2022; 68:303-314. [PMID: 35167378 DOI: 10.1139/cjm-2021-0242] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a potential health threat in the highly mobile society of the world. Also, there are concerns regarding the co-infections occurring in COVID-19 patients. Herpes zoster (HZ) is now being reported as a co-infection in COVID-19 patients. It is a varicella-zoster virus induced viral infection affecting older people and immunocompromised individuals. Reactivation of HZ infection in COVID-19 patients are emerging and the mechanism of reactivation is still unknown. A most convincing argument would be, increased psychological and immunological stress leading to HZ in COVID-19 patients, and this review justifies this argument.
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Affiliation(s)
- Rakesh Ravishankar Rahangdale
- Manipal Academy of Higher Education, 76793, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutical Biotechnology, Manipal, India;
| | - Tenzin Tender
- Manipal Academy of Higher Education, 76793, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutical Biotechnology, Manipal, India;
| | - Sridevi Balireddy
- Manipal Academy of Higher Education, 76793, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutical Biotechnology, Manipal, India;
| | - Mukesh Pasupuleti
- Central Drug Research Institute, 30082, Microbiology Division, Lucknow, India;
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Tang J, Tao J, Luo G, Zhu J, Yao M. Analysis of Risk Factors and Construction of a Prediction Model of Motor Dysfunction Caused by Limb Herpes Zoster. J Pain Res 2022; 15:367-375. [PMID: 35153514 PMCID: PMC8827162 DOI: 10.2147/jpr.s346564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/28/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jiayi Tang
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
- Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Jiachun Tao
- Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Ge Luo
- Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Jianjun Zhu
- Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
| | - Ming Yao
- Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China
- Correspondence: Ming Yao, Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing and The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Nanhu District, Jiaxing City, Zhejiang Province, People’s Republic of China, Tel +86 573 13456218632, Email
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24
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Wright SJ, Khedr A, Bartlett BN, Jama AB, Mushtaq H, Wahab A, Khan SA. Subacute necrotizing fasciitis of the posterior neck disguised as a herpes zoster infection: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221123295. [PMID: 36147591 PMCID: PMC9486268 DOI: 10.1177/2050313x221123295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Necrotizing fasciitis is a rare soft tissue infection characterized by a rapidly spreading infection of the subcutaneous tissue. Early diagnosis is important as it requires immediate and complete debridement of infected tissues and antibiotic therapy. Necrotizing fasciitis usually involves the extremities, abdomen, and groin, but rarely involves the head and neck. Necrotizing fasciitis has an aggressive course; however, in rare cases, it can present in a subacute indolent form which can be misdiagnosed as other cutaneous diseases. Our case is a unique presentation of subacute necrotizing fasciitis of the posterior neck, which was initially diagnosed as a herpes zoster infection, in a patient with undiagnosed diabetes mellitus, which was complicated with diabetic ketoacidosis and sepsis.
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Affiliation(s)
| | - Anwar Khedr
- Critical Care, Mayo Clinic Health System, Mankato, MN, USA
| | | | - Abbas B Jama
- Critical Care, Mayo Clinic Health System, Mankato, MN, USA
| | - Hisham Mushtaq
- Critical Care, Mayo Clinic Health System, Mankato, MN, USA
| | - Abdul Wahab
- Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN, USA
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25
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Adimora-Onwuka D, Hall MAK. Beware the Unexpected Infection: Disseminated Varicella Zoster Virus Mimicking A Drug Eruption. J Investig Med High Impact Case Rep 2022; 10:23247096221117785. [PMID: 35968563 PMCID: PMC9379951 DOI: 10.1177/23247096221117785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Adverse cutaneous reactions to medications are not uncommon and may
resemble viral infection and vice versa, complicating diagnosis. We
describe the case of a 79-year-old male with cholangiocarcinoma with
liver and presumed lung metastasis who presented with abdominal pain
and was admitted with ileitis with partial small bowel obstruction. He
had a widespread papulovesicular rash with hemorrhagic center, mostly
on his face, chest, and back. The rash was initially thought to be a
drug eruption, but was eventually diagnosed via dermatopathological
examination as disseminated varicella zoster virus (VZV) infection.
Steroid treatment was discontinued, and airborne precautions were
initiated. Polymerase chain reaction for VZV was obtained and
intravenous acyclovir treatment was begun. This case of VZV, initially
suspected to be an adverse drug reaction, highlights the importance of
early identification of a highly infectious lesion and the importance
of early infection control measures, given the implications of
exposure to VZV for health care personnel.
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Affiliation(s)
- Dina Adimora-Onwuka
- Emory Saint Joseph’s Hospital, Atlanta, GA, USA
- Emory University School of Medicine, Division of Hospital Medicine, Atlanta, GA, USA
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Shah S, Baral B, Chamlagain R, Murarka H, Raj Adhikari Y, Sharma Paudel B. Reactivation of herpes zoster after vaccination with an inactivated vaccine: A case report from Nepal. Clin Case Rep 2021; 9:e05188. [PMID: 34934501 PMCID: PMC8650754 DOI: 10.1002/ccr3.5188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/20/2021] [Accepted: 11/25/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 has been linked to a number of cutaneous symptoms in COVID-19 patients. Although herpes zoster (HZ) was the first sign of COVID-19 infection in several patients, cases of HZ after COVID-19 vaccination are rare. Here, we report a case of 51-year-old male patient with herpes zoster after Sinopharm (Vero cell) vaccination.
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Affiliation(s)
- Sangam Shah
- Maharajgunj Medical CampusInstitute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Bikash Baral
- Tribhuvan University Teaching HospitalMaharajgunjNepal
| | | | - Hritik Murarka
- Maharajgunj Medical CampusInstitute of MedicineTribhuvan UniversityMaharajgunjNepal
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Affiliation(s)
- Neeraja Murali
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
| | - Sahar Morkos El Hayek
- Washington University in Saint Louis, 660 S Euclid Avenue CB 8072, St Louis, MO 63110, USA
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Yun G, Kim E, Baik J, Do W, Jung YH, You CM. Diagnosis and management of ophthalmic zoster sine herpete accompanied by cervical spine disc protrusion: A case report. World J Clin Cases 2021; 9:7588-7592. [PMID: 34616830 PMCID: PMC8464478 DOI: 10.12998/wjcc.v9.i25.7588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Zoster sine herpete (ZSH) can be misdiagnosed because there are no typical vesicular eruptions characterized by a dermatomal distribution. However, incorrect treatment due to a misdiagnosis can lead to severe pain and fatal complications.
CASE SUMMARY A 75-year-old woman complained of sudden onset right shoulder pain and atypical headache. After 18 d, sudden hearing loss occurred in the left ear. In serology tests conducted after the onset of hearing loss, varicella-zoster virus IgM was positive. She had no history of a rash or trauma. Under the suspicion of ZSH, antiviral treatment and stellate ganglion block were administered four times, and the pain was effectively controlled.
CONCLUSION Early diagnosis and treatment of ZSH can help not only by reducing pain but also by preventing fatal complications.
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Affiliation(s)
- Giyoung Yun
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
- Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Yangsan 50612, South Korea
| | - Eunsoo Kim
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
- Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Yangsan 50612, South Korea
| | - Jiseok Baik
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Wangseok Do
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Young-Hoon Jung
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Chang-Min You
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
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Herpes zoster after COVID vaccination. Int J Infect Dis 2021; 111:169-171. [PMID: 34428545 PMCID: PMC8379763 DOI: 10.1016/j.ijid.2021.08.048] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 01/30/2023] Open
Abstract
COVID-19 presents in various ways, but mainly as a pulmonary disease (Marzano, 2020). Skin manifestations have been reported, including reactivation of the varicella-zoster virus (Marzano, 2020). Our case report describes two adults developing herpes zoster after vaccination with tozinameran (the Pfizer-BioNTech COVID-19 mRNA vaccine). A possible cause for this reaction is a transient lymphocytopenia that occurs after the vaccination — similar to that in COVID-19 disease (Mulligan, 2020; Wang, 2020; Qin, 2020; Brabilla, 2020; Wang, 2020; Wei, 2017). In the context of vaccinating older and/or immunocompromised adults, our observations can be the starting point for further evaluation of a possible relationship between COVID-19, COVID vaccines, and herpes zoster.
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30
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Lai SW, Liao KF, Lin CL, Kuo YH, Liu CS, Hwang BF. The incidence rate of herpes zoster in inflammatory bowel disease: A meta-analysis of cohort studies. Medicine (Baltimore) 2021; 100:e26863. [PMID: 34414937 PMCID: PMC8376306 DOI: 10.1097/md.0000000000026863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Inflammatory bowel disease is associated with an increased risk of opportunistic infections. This study aimed to investigate the incidence rate of herpes zoster in patients with inflammatory bowel disease.A meta-analysis was conducted by searching PubMed literature published from January 2000 to July 2019. The main outcome was the incidence rate of a new diagnosis of herpes zoster in patients previously diagnosed with inflammatory bowel disease. The incidence rate ratio (IRR) and 95% confidence interval (95% CI) for herpes zoster associated with inflammatory bowel disease was measured.A total of 6 eligible cohort studies matching the entry criteria were included in the meta-analysis, providing 216,552 participants with inflammatory bowel disease and 790 events of herpes zoster among these participants with inflammatory bowel disease. The pooled incidence rate of developing herpes zoster was 10.41 per 1000 person-years in the inflammatory bowel disease group and 6.10 per 1000 person-years in the non-inflammatory bowel disease group, respectively. The meta-analysis demonstrated that patients with inflammatory bowel disease were associated with 1.68-fold increased risk of developing herpes zoster when compared to those without inflammatory bowel disease (IRR = 1.68, 95% CI = 1.53-1.84). Crohn disease and ulcerative colitis were associated with an increased risk of developing herpes zoster (IRR = 1.67, 95% CI = 1.40-1.98 for Crohn disease and IRR = 1.49, 95% CI = 1.34-1.65 for ulcerative colitis, respectively).Patients with inflammatory bowel disease are at increased risk of developing herpes zoster. We suggest that the vaccination should be considered at the time of inflammatory bowel disease being diagnosed.
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Affiliation(s)
- Shih-Wei Lai
- Department of Public Health, College of Public Health, and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Hung Kuo
- Department of Research, Taichung Tzu Chi Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
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31
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Sahra S, Jahangir A, Gavica MC, Mobarakai N, Jahangir A. First case report of pulmonary embolism with Zoster Sine Herpete. Respir Med Case Rep 2021; 33:101462. [PMID: 34401298 PMCID: PMC8349081 DOI: 10.1016/j.rmcr.2021.101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 11/02/2022] Open
Abstract
Background Varicella-Zoster Virus (VZV) infection is known to cause coagulation abnormalities leading to pulmonary embolism and ischemic strokes. The incidence of vascular and thrombotic complications with Zoster Sine Herpete has been reported very infrequently in the medical literature. Case presentation A 32-year-old man with no significant past medical history presented to Emergency Room with right-sided facial weakness and headache. We saw no rash on physical examination. A sub-segmental pulmonary embolus was found on C.T. angiography of the chest. VZV was detected on Lumbar Puncture studies. The patient responded well to anti-viral treatment and was discharged home without any complications. Conclusion The suspicion of thrombo-embolic complications should be high with Zoster Sine Herpete. Screening for coagulopathies and timely initiation of anticoagulation should be carried out in appropriate clinical settings.
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Affiliation(s)
- Syeda Sahra
- Staten Island University Hospital, Staten Island, NY, 10305, USA
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32
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Soydas Turan B, Bozkurt MF. Unusual Presentation of Herpes Zoster Infection Mimicking Soft Tissue Metastases of Breast Cancer on 18F-FDG PET/CT Imaging. Clin Nucl Med 2021; 46:669-670. [PMID: 33782282 DOI: 10.1097/rlu.0000000000003580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Herpes zoster infection caused by reactivation of dormant varicella zoster virus results in painful vesicular rash in corresponding dermatome. We report a case of a 56-year-old woman with breast cancer who was referred to PET/CT scan for adjuvant chemotherapy response assessment. Her scan showed multiple FDG-avid skin lesions. Blinded to the patient's clinical information, these skin lesions initially looked suspicious for soft tissue metastases. However, the patient history revealed that she had been experiencing herpes zoster infection during the scan, and these lesions with FDG uptake were eventually confirmed to be caused by herpes zoster infection by physical examination.
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Affiliation(s)
- Basak Soydas Turan
- From the Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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33
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Dilip M, Paz-Soldan G, Carvajal Mock ME, Brevil A. Successful Ultrasound-Guided Erector Spinae Plane Block for Herpes Zoster in the Emergency Department: A Case Report. J Emerg Med 2021; 60:e73-e76. [PMID: 33353812 DOI: 10.1016/j.jemermed.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/01/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The varicella zoster virus, which lies dormant in the dorsal root ganglion, can be reactivated as herpes zoster in times of acute stress or immunosuppression. The herpes zoster lesions can be very painful, both at the time of eruption and after healing, as postherpetic neuralgia. During the acute outbreak time period, many patients visit the emergency department (ED) for pain control, often requiring opioids. CASE REPORT Here, we demonstrate two cases for which an erector spinae plane (ESP) nerve block with ropivicaine was used as an alternative to opioids, resulting in immediate and safe analgesia in the ED. Both patients had lesions across the back that were significantly impairing their daily lives; one with distribution in the thoracic region, one in the lumbar region. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ESP blocks can offer quick, easy, and effective analgesia in the ED and can be used in place of parenteral or oral analgesia. It also can be used to reduce opioid prescriptions issued from the ED. Further studies can be done to confirm the efficacy of ESP blocks against opioids through prospective trials.
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Affiliation(s)
- Monisha Dilip
- Department of Emergency Medicine, SUNY Downstate College of Medicine, Brooklyn, New York
| | - Gonzalo Paz-Soldan
- Department of Emergency Medicine, SUNY Downstate College of Medicine, Brooklyn, New York
| | | | - Alex Brevil
- Department of Emergency Medicine, SUNY Downstate College of Medicine, Brooklyn, New York
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Smith A, Doran S, Daly M, Kennedy C, Barry M. Effect of an Online Reimbursement Application System on Prescribing of Lidocaine 5% Medicated Plaster in the Republic of Ireland. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:133-140. [PMID: 32430656 DOI: 10.1007/s40258-020-00586-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND The lidocaine 5% medicated plaster, Versatis®, has one therapeutic indication listed on the Summary of Product Characteristics-symptomatic relief of post-herpetic neuralgia (PHN) in adults. Increased expenditure on Versatis® suggests that there is considerable off-label use. To support the appropriate use of Versatis®, the Health Service Executive's Primary Care Reimbursement Service (PCRS) introduced a reimbursement application system for Versatis® from 1 September 2017. OBJECTIVE The aim of this study was to investigate the effect of introducing a reimbursement application system on Versatis® prescribing under the General Medical Services (GMS) scheme. METHODS This study was carried out using prescription dispensing data from the PCRS pharmacy claims database. We carried out segmented linear regression to assess changes in the Versatis® prescribing rate per 1000 GMS eligible population, before and after the introduction of the online reimbursement application system. RESULTS The results of the segmented regression analysis show that there was a statistically significant level (- 4.91, p < 0.001) and trend change (- 0.69, p < 0.001) in the rate of Versatis® prescribing post-introduction of the reimbursement application system. In the year prior to the introduction of the system, 2016, the annual GMS expenditure on Versatis® lidocaine 5% patches was over €27 million, whereas the GMS expenditure in 2018 was reduced to just over €2 million. CONCLUSION In our study, a substantial decrease in the dispensing of Versatis® was seen after the implementation of a reimbursement application system. Prescribing of Versatis® should be restricted to patients with a diagnosis of PHN not only to reduce costs, but to ensure evidence-based use of this medication.
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Affiliation(s)
- Amelia Smith
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin 8, Ireland.
- Medicines Management Programme, Health Service Executive, St. James' Hospital, Dublin 8, Ireland.
| | - Stephen Doran
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin 8, Ireland
- Medicines Management Programme, Health Service Executive, St. James' Hospital, Dublin 8, Ireland
| | - Maria Daly
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin 8, Ireland
- Medicines Management Programme, Health Service Executive, St. James' Hospital, Dublin 8, Ireland
| | - Cormac Kennedy
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin 8, Ireland
| | - Michael Barry
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Centre for Health Sciences, St. James' Hospital, Dublin 8, Ireland
- Medicines Management Programme, Health Service Executive, St. James' Hospital, Dublin 8, Ireland
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35
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Altaf I. Herpes Zoster Co-Infection with COVID-19: A Case Series. BALI JOURNAL OF ANESTHESIOLOGY 2021. [DOI: 10.4103/bjoa.bjoa_222_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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36
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Monib S, Pakdemirli E. Shingles (Herpes Zoster) Mimicking Acute Abdomen. Cureus 2020; 12:e10762. [PMID: 33150112 PMCID: PMC7603891 DOI: 10.7759/cureus.10762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Shingles is a very well-known viral infection caused by the varicella-zoster virus leading to painful skin rash. Although shingles can occur anywhere, it most often appears as a single stripe of blisters around the hypochondriac region. We are presenting a rare atypical presentation of shingles, as our patient presented with a picture of the acute abdomen a couple of days prior to the eruption of skin lesions.
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Affiliation(s)
- Sherif Monib
- Breast Surgery, West Hertfordshire Hospitals NHS Trust, St. Albans and Watford General Hospitals, London, GBR
| | - Emre Pakdemirli
- Radiology, West Hertfordshire Hospitals NHS Trust, St. Albans City Hospital, London, GBR
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37
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Dai S, Huang X, Chen Y, Wang M, Zheng H, Zeng K, Li L. Bilateral asymmetrical herpes-zoster with Ramsay hunt syndrome in an immunocompetent adult. Virol J 2020; 17:123. [PMID: 32799908 PMCID: PMC7429785 DOI: 10.1186/s12985-020-01392-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Bilateral herpes zoster (BHZ) is an atypical presentation of herpes zoster (HZ), with few cases reported before. Ramsay Hunt syndrome (RHS) is an uncommon complication of VZV infection. Cases of BHZ with RHS in immunocompetent adults have been reported rarely. Case presentation We described an immunocompetent adult who suffered from left-sided thoracic herpes zoster and contralateral RHS simultaneously, and summarizes the characteristics of BHZ. Conclusions Cases of BHZ with RHS in immunocompetent adults have not been reported previously. Antivirus - glucocorticoid combination therapy showed a good effect in this case.
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Affiliation(s)
- Siqi Dai
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China
| | - Xiaowen Huang
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China
| | - Yuxiang Chen
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China
| | - Menglei Wang
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China
| | - Huanxin Zheng
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China
| | - Kang Zeng
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.
| | - Li Li
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.
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38
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Zhou J, Li J, Ma L, Cao S. Zoster sine herpete: a review. Korean J Pain 2020; 33:208-215. [PMID: 32606265 PMCID: PMC7336347 DOI: 10.3344/kjp.2020.33.3.208] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Zoster sine herpete (ZSH) is one of the atypical clinical manifestations of herpes zoster (HZ), which stems from infection and reactivation of the varicella-zoster virus (VZV) in the cranial nerve, spinal nerve, viscera, or autonomic nerve. Patients with ZSH display variable symptoms, such as neuralgia, however, different from HZ, ZSH show no zoster, which makes clinical diagnosis difficult. ZSH not only causes initial symptoms, such as neuropathic pain in the affected nerve, Bell palsy, and Ramsay Hunt syndrome, but also postherpetic neuralgia and fatal complications such as VZV encephalitis and stroke. The misdiagnosis of ZSH and tardy antiviral treatment may lead to severe ZSH sequelae. We review the publications related to ZSH, especially its diagnosis with VZV DNA and/or anti-VZV immunoglobulin (IgG and IgM). More work about ZSH, especially ZSH epidemiological survey and guidelines for its diagnosis and treatment, are needed because most of the present studies are case reports.
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Affiliation(s)
- Junli Zhou
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Juan Li
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Lulin Ma
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Song Cao
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical University, Zunyi, China
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Elsaie ML, Youssef EA, Nada HA. Herpes zoster might be an indicator for latent COVID 19 infection. Dermatol Ther 2020; 33:e13666. [PMID: 32447801 PMCID: PMC7267085 DOI: 10.1111/dth.13666] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
Various cutaneous manifestations have been observed in patients with COVID‐19 infection. Herpes zoster is a viral skin disease caused by varicella zoster that remains dormant in the dorsal root ganglia of cutaneous nerves following a primary chicken pox infection. In this report, we describe two cases COVID infection who first presented with herpes zoster. We are here by suggesting that the clinical presentation of HZ at the time of the current pandemic even in patients giving mild or no suggestive history of upper respiratory symptoms should be considered as an alarming sign for a recent subclinical SARS CoV2 infection.
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Affiliation(s)
- Mohamed L Elsaie
- Department of Dermatology and Venereology, National Research Centre, Giza, Egypt
| | - Eman A Youssef
- Department of Clinical Pathology, Cairo University, Giza, Egypt
| | - Hesham A Nada
- Department of Dermatology, Venereology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Rosamilia LL. Herpes Zoster Presentation, Management, and Prevention: A Modern Case-Based Review. Am J Clin Dermatol 2020; 21:97-107. [PMID: 31741185 DOI: 10.1007/s40257-019-00483-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Herpes zoster (HZ) is a common cutaneous entity with protean clinical presentations, management options, complication rates, and prevention strategies, all of which are rife with dogma. During an inpatient consultation for HZ, have you ever been approached by a frantic staff or family member, worried that a pregnant, elderly, or infant contact will be 'infected' if they get too close? Have your patients ever asked you about their risk of having HZ twice, or claimed that they have frequent 'recurrences'? In what timeline should antiviral therapy be employed? Is there evidence for prednisone or gabapentin in acute HZ treatment? Who should be vaccinated against HZ and what are the benefits and risks? In case-based form, these and other complex but common scenarios will be examined using clinical and viral mechanistic clues, along with updated treatment and prevention guidelines, to provide a modern HZ case management compendium, comprehensive of the diverse age and health populations now presenting with this condition.
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Abstract
The incidence of herpes zoster, more commonly known as shingles, is approximately 1.2 million individuals per year, which has been increasing worldwide. While the most common presentation of zoster is a rash and acute neuritis (the pain associated with the rash) within one or more contiguous dermatomes, other more serious manifestations such as herpes zoster ophthalmicus, acute retinal necrosis, Ramsay Hunt syndrome (herpes zoster oticus), aseptic meningitis, pneumonitis, bacterial superinfection and disseminated zoster ought to be considered by the clinician. This case report serves as a reminder for the emergency physician to bear these very serious complications in mind during the evaluation of a patient with suspected herpes zoster infection.
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Affiliation(s)
- Emily Drone
- Emergency Medicine, University of Central Florida/Hospital Corporation of America/Graduate Medical Education Consortium and Osceola Regional Medical Center, Olrando, USA
| | - Latha Ganti
- Emergency Medicine, Envision Physician Services, Orlando, USA
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Karadag AS, Elmas ÖF, Altunay İK. Cutaneous manifestations associated with HIV infections: A great imitator. Clin Dermatol 2019; 38:160-175. [PMID: 32513397 DOI: 10.1016/j.clindermatol.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
HIV is associated with an increased incidence of mucocutaneous disorders, with the overwhelming majority of HIV-infected individuals being afflicted with skin diseases during the course of the infection. Skin diseases in HIV patients are rarely fatal, but they have a significant effect on the quality of life. The immunologic stage of the infection and the use of highly active antiretroviral therapy (HAART) are the main elements that determine the spectrum of the mucocutaneous involvement. Many skin diseases may occur simultaneously in HIV patients, and the course of these diseases may or may not be different than it is in HIV-negative individuals. The unusual, severe, and different presentations of the mucocutaneous involvement make HIV one of the great imitators in dermatology.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ömer Faruk Elmas
- Department of Dermatology, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey.
| | - İlknur Kıvanç Altunay
- Department of Dermatology, Şişli Hamidiye Etfal Research and Training Hospital, Health Science University, Istanbul, Turkey
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Kim SY, Lee CH, Min C, Kim HJ, Choi HG. Herpes zoster does not increase the risk of sudden sensory neural hearing loss: a longitudinal follow-up study using a national sample cohort. Int J Audiol 2019; 59:173-178. [PMID: 31536385 DOI: 10.1080/14992027.2019.1666309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: This study aimed to investigate the risk of sudden sensorineural hearing loss (SSNHL) in Herpes zoster patients from a representative population cohort.Design: A longitudinal follow-up studyStudy sample: Data were obtained from the Korean National Health Insurance Service-National Sample Cohort for the period from 2002 to 2013. We matched 61,702 subjects in the Herpes zoster group with subjects in a control group (246,808 subjects with no history of Herpes zoster) based on demographic factors (age, sex, income, and region of residence) and medical history (diabetes, dyslipidemia, and hypertension). The crude (simple) and adjusted hazard ratios (HRs) for Herpes zoster with SSNHL were analysed using the Cox-proportional hazard model.Results: Only 0.5% (338/61,364) of the Herpes zoster group and 0.7% (1664/245,144) of the control group showed SSNHL. The Herpes zoster group did not exhibit a higher rate of SSNHL (adjusted HR = 0.81, 95% CI = 0.72-0.91, p < 0.001) than the control group. In subgroup analyses, no age subgroups showed a significant risk of SSNHL in the Herpes zoster group.Conclusions: After adjusting for confounding factors, the risk of SSNHL did not increase in the Herpes zoster group compared with the control group.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang-Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Korea
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Jia QN, Jin HZ, Zeng YP. An Elderly Woman With Violaceous Swelling With Telangiectasia and Necrosis on the Face. JAMA Dermatol 2019; 155:615-616. [PMID: 30916711 DOI: 10.1001/jamadermatol.2018.5316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Qian-Nan Jia
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong-Zhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Ping Zeng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Affiliation(s)
- Darren Shu Jeng Ting
- Sunderland Eye Infirmary, Sunderland, UK
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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Jeon Y, Lee H. Ramsay Hunt syndrome. J Dent Anesth Pain Med 2018; 18:333-337. [PMID: 30637343 PMCID: PMC6323042 DOI: 10.17245/jdapm.2018.18.6.333] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 12/22/2022] Open
Abstract
Ramsay Hunt syndrome is a type of acute herpes zoster, which occurs by reactivation of the varicella-zoster virus at the geniculate ganglion. Clinical presentation of Ramsay Hunt syndrome includes a vesicular rash on the ear (herpes zoster oticus) or in the oral mucosa accompanied by acute peripheral facial nerve paralysis. Other cranial nerves such as V, IX, XI, and XII are often involved. Additional variability of the clinical picture of Ramsay Hunt syndrome is produced by varying patterns of skin involvement explained by individual anastomoses between cranial and cervical nerves. Combination treatment containing anti-viral agents and steroids is recommended for the treatment of Ramsay Hunt syndrome. Additionally, early diagnosis of Ramsay Hunt syndrome is a crucial factor to improve damaged nerves in Ramsay Hunt syndrome, which initiates treatment as soon as possible.
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Affiliation(s)
- Younghoon Jeon
- Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Heryim Lee
- Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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Sorel O, Messaoudi I. Varicella Virus-Host Interactions During Latency and Reactivation: Lessons From Simian Varicella Virus. Front Microbiol 2018; 9:3170. [PMID: 30619226 PMCID: PMC6308120 DOI: 10.3389/fmicb.2018.03170] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/07/2018] [Indexed: 01/11/2023] Open
Abstract
Varicella zoster virus (VZV) is a neurotropic alphaherpesvirus and the causative agent of varicella (chickenpox) in humans. Following primary infection, VZV establishes latency in the sensory ganglia and can reactivate to cause herpes zoster, more commonly known as shingles, which causes significant morbidity, and on rare occasions mortality, in the elderly. Because VZV infection is highly restricted to humans, the development of a reliable animal model has been challenging, and our understanding of VZV pathogenesis remains incomplete. As an alternative, infection of rhesus macaques with the homologous simian varicella virus (SVV) recapitulates the hallmarks of VZV infection and thus constitutes a robust animal model to provide critical insights into VZV pathogenesis and the host antiviral response. In this model, SVV infection results in the development of varicella during primary infection, generation of an adaptive immune response, establishment of latency in the sensory ganglia, and viral reactivation upon immune suppression. In this review, we discuss our current knowledge about host and viral factors involved in the establishment of SVV latency and reactivation as well as the important role played by T cells in SVV pathogenesis and antiviral immunity.
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Affiliation(s)
- Océane Sorel
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
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Peng RM, Guo YX, Xiao GG, Lu Q, Sun BJ, Hong J. Clinical Manifestations and Characteristics of In Vivo Confocal Microscopy in Varicella Zoster Virus-Related Corneal Endotheliitis. Ocul Immunol Inflamm 2018; 27:1270-1279. [PMID: 30252558 DOI: 10.1080/09273948.2018.1521435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Rong-mei Peng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China
| | - Yu-xin Guo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China
| | - Ge-ge Xiao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China
| | - Qing Lu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China
| | - Bin-jia Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China
| | - Jing Hong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China
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Kornfeind EM, Visalli RJ. Human herpesvirus portal proteins: Structure, function, and antiviral prospects. Rev Med Virol 2018; 28:e1972. [PMID: 29573302 DOI: 10.1002/rmv.1972] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/26/2018] [Accepted: 01/27/2018] [Indexed: 01/28/2023]
Abstract
Herpesviruses (Herpesvirales) and tailed bacteriophages (Caudovirales) package their dsDNA genomes through an evolutionarily conserved mechanism. Much is known about the biochemistry and structural biology of phage portal proteins and the DNA encapsidation (viral genome cleavage and packaging) process. Although not at the same level of detail, studies on HSV-1, CMV, VZV, and HHV-8 have revealed important information on the function and structure of herpesvirus portal proteins. During dsDNA phage and herpesviral genome replication, concatamers of viral dsDNA are cleaved into single length units by a virus-encoded terminase and packaged into preformed procapsids through a channel located at a single capsid vertex (portal). Oligomeric portals are formed by the interaction of identical portal protein monomers. Comparing portal protein primary aa sequences between phage and herpesviruses reveals little to no sequence similarity. In contrast, the secondary and tertiary structures of known portals are remarkable. In all cases, function is highly conserved in that portals are essential for DNA packaging and also play a role in releasing viral genomic DNA during infection. Preclinical studies have described small molecules that target the HSV-1 and VZV portals and prevent viral replication by inhibiting encapsidation. This review summarizes what is known concerning the structure and function of herpesvirus portal proteins primarily based on their conserved bacteriophage counterparts and the potential to develop novel portal-specific DNA encapsidation inhibitors.
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Affiliation(s)
- Ellyn M Kornfeind
- Department of Biomedical Sciences, Mercer University School of Medicine, Savannah, GA, USA
| | - Robert J Visalli
- Department of Biomedical Sciences, Mercer University School of Medicine, Savannah, GA, USA
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50
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Park YM. Comprehensive review and update on herpes zoster. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2018. [DOI: 10.5124/jkma.2018.61.2.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Young Min Park
- Department of Dermatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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