Herpes Zoster (HZ), commonly called shingles, is a distinctive syndrome caused by reactivation of varicella zoster virus (VZV), which also causes chickenpox. However, adverse effects related to their immunosuppression have been observed, including an increased propensity to viral infections. A true Koebner response can be confirmed by experimentally reproducing lesions with different methods of injury. After 2 years in the OPT Extend study, 64.5% of the 1,912 patients remaining in the study were PASI 75 responders. The current study is a follow-up from an initial report on the first nine years of follow-up, which found no statistically significant association between treatment with biological medications and HZ. The current report adds an additional 73,569 patients and 303,130 person-years of follow-up and considers biological monotherapy and combination therapy separately. In addition, post clinical epidemiological research highly contributes to our understanding of whether a current treatment is efficient and to what extent.
The authors say their results may lend support to prophylactic vaccination against VZV in patients with psoriasis and multiple risk factors for HZ. Conversely, a patient who does not develop skin lesions with one type of injury is not expected to exhibit Koebner phenomenon with another type of injury. – at each follow-up visit based on efficacy and side effects. The authors conclude that as a minimum, patients treated with biological medications together with methotrexate should be aware of the possible increased risk of HZ.