Reactivation of latent varicella-zoster virus in sensory neurons to cause herpes zoster (shingles) is common in adults 50 years of age and older; half of adults experience an episode by age 85 years. The aim of this report is to present the outcomes of PHN management with concomitant use of pharmacological treatment and sympathetic nerve blocks. The impact of persistent pain on physical functioning should be assessed. There is evidence to support using antiviral therapy and possibly low-dose tricyclic antidepressants to prevent postherpetic neuralgia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001861/ (accessed 4 March 2014). [Medline]. In the first article, Bethany A.
Pain and temperature detection systems are hypersensitive to light mechanical stimulation, leading to severe pain (allodynia). Although the vaccine was most effective in younger patients, most cases of herpes zoster and PHN emerge in older patients. PHN. 5th ed. Missouri: Elsevier Saunders, 2013. Clinicians treating patients with PHN may consider a trial of lidocaine 5 % patch monotherapy before resorting to a systemic therapy, or alternatively, may consider administering the lidocaine 5 % patch in combination with a tricyclic antidepressant or a gabapentinoid to provide more rapid analgesic response and lower the dose requirement of systemic therapies. Limitation: Small number of patients and limited follow-up period.
http://www.cdc.gov/shingles/about/index.html (accessed 4 March 2014). ↑ 5.05.1 Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc 2009;84(3): 274-280. ↑ Drolet M, Brisson M, Schmader KE,Levin MJ,Johnson R,Oxman MN, et al. The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study. The management of PHN depends on the pain characteristics and time from the onset of HZ symptoms; in addition, PHN management is guided by frequently published meta-analyses and recommendations that focus on the various types of chronic pain [6−11].
Zoster vaccine live decreases the incidence of HZ and may also minimize the chance of developing PHN. Herpes zoster treatment &amp; management. http://emedicine.medscape.com/article/1132465-treatment (accessed 13 Mar 2014). Benzon HT, Chekka K, Darnule A, Chung B, Wille O, Malik K. Pathology implications for the physical therapist. Annually, in the United States, shingles affects approximately 200,000 healthy people aged 50-59 years. Missouri: Saunders Elsevier, 2009.
Then, with no warning, the virus becomes active again. Risk of herpes/herpes zoster during anti-tumor necrosis factor therapy in patients with rheumatoid arthritis. Systematic review and meta-analysis. Joint Bone Spine 2013:1-7. VRS was scored before starting the treatment and at the end of the therapeutic period. Herpes zoster among persons living with HIV in current ART era. J Acquir Immune Defic Syndr 2012;61(2):203-7.
↑ Isgro J, Levy DM, LaRussa P, Imundo LF, Eichenfield AH. Descriptive analysis of herpes zoster in childhood-onset systemic lupus erythmatosus. Pediatr Rheumatol 2012;10(suppl 1):A25. ↑ 12.012.1 Dworkin RH, O’Connor AB, Audette J, Baron R, Gourlay GK, Haanpaa ML, et al. Only patients with an initial NRS score greater than 4 (5−10) were included in the data analysis. Herpes zoster and postherpetic neuralgia: prevention and management. ↑ Kolsek M.
TENS-an alternative to antiviral drugs for acute herpes zoster treatment and postherpetic neuralgia prevention. Pain. ↑ Pereira LM, Obara K, Dias JM, Menacho MO, Lavado EL, Cardoso JR. Lidocaine gel (5%) in placebo-controlled study showed significant relief in 23 patients studied. Clin Rehab 2011;25:647-58. ↑ Koh MJ, Seah PP, Teo RY. Zosteriform herpes simplex.
Singapore Med J 2008;49:e59-60. ↑ Patel GA, Siperstein RD, Ragi G, Schwartz RA. Ten patients (58.82%) showed variable grades of improvement both at the end of the treatment sessions and at the end of the 3 months follow up. Acta Dermatovenerol Alp Panonica Adriat 2009;18:179-82.