Clinical analysis of 53 cases of disseminated herpes zoster.

Abstract

Objective To investigate the predisposing factors and clinical features of disseminated herpes zoster, and to explore factors influencing postherpetic neuralgia. Methods Clinical data were collected from 53 patients with disseminated herpes zoster and 809 patients with common herpes zoster between 2012 and 2015, and analyzed retrospectively. Logistic regression analysis was used to assess factors influencing the occurrence of and pain intensity in disseminated herpes zoster, as well as the occurrence of postherpetic neuralgia. Results No significant difference in patients′ age was observed between the disseminated and common herpes zoster groups (56.66 ± 17.24 vs. 56.50 ± 15.51 years, t = 0.071, P > 0.05) , but there was a significant difference in the gender ratio between the two groups (χ2 = 8.16, P = 0.004). The incidence rates of bullae, pustules and fever were all significantly higher in the disseminated herpes zoster group than in the common herpes zoster group (15.09% vs. 3.58%, χ2 = 16.04, P < 0.01; 47.17% vs. 26.82%, χ2 = 10.20, P < 0.01; 30.19% vs. 8.03%, χ2 = 28.68, P < 0.01). The disseminated herpes zoster group also showed significantly higher pain scores at admission compared with the common herpes zoster group (Median [P25-P75]: 6 [4-7.5] vs. 5[3-7], Z = -3.460, P = 0.001). Logistic regression analysis revealed that gender, age, fatigue and HIV infection were significantly associated with the occurrence of disseminated herpes zoster (all P < 0.05). Additionally, HIV infection (OR = 5.570, 95% CI: 1.196-25.939, P = 0.029) , gender (OR = 0.166, 95% CI: 0.029 - 0.945, P = 0.043) , age (OR = 1.064, 95% CI: 1.010-1.119, P = 0.019) and the number of days that antiviral therapy lasted (OR = 0.669, 95% CI: 0.505-0.885, P = 0.005) were all factors influencing the occurrence of postherpetic neuralgia. Conclusion Male, old age, fatigue and especially HIV infection are risk factors for the occurrence of disseminated herpes zoster, and male, old age and antiviral therapy duration may be associated with the occurrence of postherpetic neuralgia. Key words: Herpes zoster; Logistic models; Neuralgia, postherpetic