Clinical Observation of Herpes Zoster

Herpes zoster characterized by the several groups of vesicles on an erythematous and edematous base situated unilaterally along the distribution of a cranial or spinal nerve leading to one posterior ganglion, often with some overflow into the neurotomes above and below. The onset is rapid, with fever and neuralgic pain(except in persons under 30, as a rule) after an incubation period of seven to 12 days. Zoster is the result of a recrudescence of varicella-zoster virus(VZV) infection. The pathogenesis of herpes zoster is not fully understood. During the course of varicella. VZV passes from lesions in the skin and mucosal surfaces into the contiguous endings of sensory nerves and transported centripetally up the sensory fibers to the sensory ganglia. Although the latent virus in the sensory ganglia retains its potential for full infectivity, reversions are sporadic and infrequent. The mechanisms involved in the reactivation of latent VZV are unclear, but a number of conditions have been associated with the occurrence and localization of herpes zoster. These include immunosuppression in Hodgkin's disease and other malignancies, administration of immunosuppressive drugs and corticosteroids, irradiaion of the spinal column, tumor involvement of the cord, dorsal root ganglia, or adjacent structures, local trauma, surgical manipulation of the spine, heavy-metal poisoning or therapy, and frontal sinusitis as a precipitant of ophthalmic zoster. To detect the general tendency of herpes zoster on these days, 120 patients of herpes zoster at the OPD of dermatology department in Ewha Womans University Hospital during 2 years from Jun 1 1978 to May 31 1980 were analized. The results are as follows: 1) It occurs frequently among females(Male:Female = 1:1.6). 2) Peak age incidence is from 50 to 59(20.0%). 3) There seems to be no seasonal predilection or correlation with varicella epidemics. Monthly distribution: from 5.0% to 11.7% Seasonal distribution: from 20.8% to 30.0% 4) Herpes zoster associated with tuberculosis and hypertension were 4 cases respectively. 5) The most frequently affected dermatomes are thoracie nerve(50.8%), cervical nerve and ophthalmic division of trigerminal nerve.