جستجوی مقالات مرتبط با کلیدواژه "herpes zoster" در نشریات گروه "پزشکی"

Herpes zoster ophthalmicus (HZO) cranial nerve palsies, such as those affecting the third cranial nerve, are very uncommon manifestations of the disease. In this study, we report a case of third cranial nerve palsy caused by HZO. A 37-year-old female patient initially showed signs of cutaneous involvement, which progressed to complete ophthalmoplegia. Her right eye had a mydriatic pupil and ptosis, and she also reported a decrease in visual acuity. Neuroimaging was used to rule out other possible causes of nerve palsies; both brain magnetic resonance imaging (MRI) and brain magnetic resonance angiography (BMRA) were normal, confirming the diagnosis of HZO. The patient was treated with an IV injection of acyclovir 400 mg three times a day for seven days, followed by one week of oral antiviral therapy. Several case studies indicate that HZO is a self-limiting disease; in our case, the symptoms subsided over the course of four months. To lessen the risk of irreversible effects, appropriate treatment should be initiated as soon as the condition is diagnosed.

Deep vein thrombosis (DVT) occurs most commonly in the lower extremities and is related to the Virchow triad. While reactivation of the varicella-zoster virus (VZV) is rare when it occurs in the lower extremity dermatome, we present and discuss herpes zoster infection in immunocompromised individuals, which has similar manifestations yet can lead to unexpected, serious, life-threatening DVT complications. A 52-year-old woman with overweight and diabetes mellitus presented to the emergency department with 3 days of fever and a sudden, painful, swollen left leg. There was no history of chickenpox, trauma, surgery, or immobilization. She was using insulin glulisine and glargine. The physical examination was normal, except for a skin eruption characterized by a vesicle-pustule-blister group that followed the L4–L5 dermatome. Laboratory tests revealed leukocytosis and increased D-dimer levels. A duplex ultrasound was performed, which showed a thrombotic filling defect in the left common femoral vein and DVT in the left leg. The patient was treated with oral acyclovir, subcutaneous injection of fondaparinux, insulin glargine, and glulisine. Her symptoms improved within 7 days during her inpatient stay. After discharge, a follow-up duplex ultrasound evaluation revealed a reduced thrombus in the left common femoral vein. This case highlights that VZV reactivation in immunocompromised individuals can be complicated by DVT. It requires heightened clinical awareness of herpes zoster and related complications with similar manifestations, to provide precise and prompt treatment, and prevent worse outcomes. (Iranian Heart Journal 2024; 25(4): 111-116)

The recent coronavirus (COVID-19) is a rapidly spreading multisystemic disease with a broad spectrum of cutaneous manifestations. Recently, DNA-based/RNA-based vaccines, inactivated vaccines, and non-replicating viral vector vaccines have been manufactured to reduce viral transmission and attenuate the morbidity and mortality of COVID-19. The neurotropic virus of varicella-zoster can reactivate spontaneously or in response to a trigger such as trauma, fever, or immunosuppression. Recently, COVID-19 infection was assumed as a potential trigger as well. Up to now, 91 cases of herpes zoster have been reported after COVID-19 vaccinations. The present study reported a case of a 69-year-old woman from Iran. She had received an Astra Zeneca COVID-19 vaccine 5 days before the skin eruption. A clinical diagnosis of herpes zoster infection was confirmed by a polymerase chain reaction (PCR) test for varicella zoster DNA. Oral acyclovir 800 mg five times a day together with gabapentin 300 mg every night resulted in the resolution of the lesions in 2 weeks with no sequelae. The present study then discussed the potential contribution of vaccination against COVID-19 and the reactivation of the varicella-zoster virus.

Terra firma-forme dermatosis (TFFD) is a rare and underdiagnosed condition that clinically presents as asymptomatic dark brown to black colored plaques that resemble dirty skin. Given the unfamiliarity of the disease, TFFD is regarded as a lesser-known phenomenon, despite the existence of a straightforward diagnostic sign. To the best of our knowledge, only a few cases of TFFD have been reported, and in the present case, the occurrence of TFFD at the site of varicella zoster secondary to wolf isotopic phenomenon in a short duration of two months after healing of lesions is the first reported case.

A 44-year-old man with a three-day history of pain in right axilla, subsequently accompanied by the appearance of vesiculopapular rashes on the right portion of his torso, attended a medical facility. The patient had neither reported any special skin contact in that area, nor fever and other symptoms. Upon examination, the examiner revealed the appearance of some other similar vesiculopapular rashes. These two affected sites were located in a linear arrangement, namely, the T7 dermatome. Considering the particular arrangement of rashes and form of manifestation, a clinical diagnosis of herpes zoster was made. The patient underwent empirical treatment of herpes zoster, including Virabex (valaciclovir) tablet 1g TDS, pregabalin capsule once nightly, and hydroxyzine hydrochloride tablet once every night. The pain and itching resolved within one week after the prescription, and the rashes mostly disappeared within 20 days. Here, the daily state of rashes are presented to the audience.

Herpes zoster (HZ), also known as shingles, is caused by the reactivation of the varicella-zoster virus (VZV). There have been several reports of HZ associated with COVID-19 vaccination, and the outcomes have varied.

In this report, we present 4 cases of patients who experienced HZ reactivation after receiving a COVID-19 vaccine. These individuals sought treatment at a pain management center due to postherpetic neuralgia (PHN). While HZ itself can be treated, post-herpetic neuralgia can persist for years, significantly impacting the patients’ quality of life. Therefore, early recognition of this adverse effect is crucial, and patients should receive specialized analgesic support promptly to prevent the development of chronic pain.

Varicella-Zoster virus (VZV) is the causative agent of herpes zoster, or "shingles." Most cases of acute herpes zoster are self-limiting, although the pain can cause significant suffering, and experience postherpetic neuralgia (PHN), particularly in older adults. Early treatment of herpetic neuralgia in the subacute phase may prevent PHN progression. This study aimed to evaluate the efficacy of memantine in the treatment of subacute neuropathic herpes zoster. 

This randomized clinical trial was performed on sixteen patients aged 18-75 years with subacute herpetic neuralgia. Patients were randomly assigned to the intervention or control group according to the inclusion and exclusion criteria (8 in each group). The duration of the study was eight weeks. Patients in the memantine group received Gabapentin 300 mg per day and memantine 5 mg twice a day. Then, after one week, the memantine dose was tapered up to 10 mg twice a day. In the control group, patients received only Gabapentin from the first week to the end of the study. DN4 questionnaire is used to measure the severity of nerve pain. The patients of both control and intervention groups completed the questionnaire before starting the treatment and it was done again after the end of the treatment period (8 weeks).

The results showed improvement in pain in patients who received Memantine along with Gabapentin in comparison with Gabapentin alone (P =0.001). Moreover, the DN4 questionnaire score evaluation indicated a significant difference only for the intervention group's Q1 variable in within-group analysis (P =0.031).

Co-administration of memantine with Gabapentin reduced the severity of subacute neuropathic herpes. In addition, memantine is expected to be a viable option for treating and relieving subacute and chronic nerve pain in patients.

 Diabetes mellitus is known to be a potential risk factor for herpes zoster (HZ). The aim of the present study was to investigate the relationship between diabetes and HZ statistically. What is the status of diabetes in people with HZ, and are diabetes and HZ associations statistically significant? Answering these questions is the main purpose of this study.

 Systematic search was carried out in four major international databases, including PubMed, Scopus, Web of Science, and Google scholar for eligible records between January 2000 and December 2020. The overall prevalence of diabetes in HZ people, studies heterogeneity, as well as geographical distribution were estimated by a random-effect model applied in comprehensive meta-analysis (V2, BioStat) software.

 Ultimately, 28 studies (29 datasets) were included in the present meta-analysis. The overall prevalence of diabetes in HZ people was estimated to be 12.7% (95% CI: 11.5%- 14%), the highest and lowest prevalence rates were 17.4% and 4% in Southeast Asian and American regions, respectively. Additionally, the odds ratio (OR) results suggested a significant association between HZ and diabetes (OR: 1.28, 95% CI: 1.18-1.38).

 The results indicate a significant association between HZ and diabetes, and this association should not be neglected. Future studies may reflect the effect of vaccination more seriously by considering this association.

COVID-19 has several different presentations including cutaneous manifestations. In this report, we introduce a case of generalized herpes zoster in a COVID-19 patient. No sign of upper or lower respiratory tract involvement was detected, but due to unexpected dissemination of the lesions, COVID-19 Polymerase Chain Reaction (PCR) was tested and revealed positive. Although the incidence of herpes zoster during COVID-19 infection has been reported previously, none of them was disseminated. Therefore, we recommend that during the pandemic of COVID-19, any unexpected disseminated herpes zoster be considered as a possible case of this disease and be quarantined until the PCR is negative.

Herpes zoster (HZ) is a viral disease caused by the reactivation of the varicella-zoster virus characterized by distinctive prodromal pain followed by herpetiform vesicular eruptions. The immunocompromised states, such as old age, diabetes, human immunodeficiency virus (HIV) infection, and immunosuppressive drugs, are known predisposing factors in this regard.

The study aimed to investigate the clinic-epidemiological profile of HZ cases attending a tertiary care center.

All consecutive cases of HZ reported to the dermatology outpatient department (OPD) at a tertiary care dermatological center in North India within January - June in 2019 were enrolled after obtaining informed consent and ethical clearance. The clinical profile of patients was noted on predesigned proforma. Laboratory investigations, including complete blood count, routine urine examination, renal function test, and blood sugar, were performed. The HIV antibody was tested by enzyme-linked immunosorbent assay in all cases. The data were analyzed by tabulation, mean, standard deviation on Microsoft Excel for Windows 10 operating system.

A total of 190 HZ cases were enrolled, that constituted 0.84% of total dermatology OPD cases of the above-mentioned duration. There were 126 male and 64 female subjects with a gender ratio of 2: 1. Out of the total number of cases, 53% were below 50 years of age, and 59% had a definite history of chickenpox. Moreover, 66 (34%) cases had comorbidities, which included 43 (22% of total cases) cases with some form of immune suppression. In addition, 11 cases were HIV positive, out of whom 2 subjects were diagnosed with HIV infection while evaluating HZ. More than 90% of cases had prodrome before eruptions. Thoracic dermatome was most commonly involved, followed by the trigeminal nerve. Corneal involvement was observed in 4 out of 11 cases of HZ ophthalmicus. The resolution period was within the range of 8 - 15 days. Moreover, 51 (27%) cases developed some complications. Postherpetic neuralgia (PHN) was present in 41 (21.5%) cases.

The HZ constituted 0.84% of total dermatology OPD in 6 months and reflected a sizable burden in a tertiary care centre. The presence of this disease in a relatively young population or in the male gender might be due to the demographic characteristics of the dependent clientele. There was a higher incidence of PHN (21.5%) in prolonged follow-up. The involvement of thoracic dermatome as the most common segment in HZ and PHN and association with diabetes mellitus is consistent with the results of other studies.

The reactivated form of the varicella-zoster virus (VZV) is responsible for chickenpox, known as herpes zoster (HZ). Although it is a self-limiting infection, it presents debilitating and painful mucosal and dermal vesicular eruptions. Early identification and management are vital to curbing the spread of HZ infection. In this extensive review, we present an overview of HZ, including its structure, pathophysiology, clinical presentation, complications, investigations, and management. Our review also highlights the prophylaxis and treatment of complications manifested by the VZV.

Herpes zoster ophthalmicus is a frequent, painful, and debilitating condition caused by the reactivation of the varicella-zoster virus alongside the ophthalmic branch of the trigeminal nerve. Twenty-five percent of adults will develop the disease during their lifetime with the risk increasing to one in two over the age of 50. Herpes zoster ophthalmicus presents with a plethora of ocular manifestations ranging from the characteristic rash in the distribution of the ophthalmic branch of the fifth cranial nerve to more severe keratouveitis, disciform keratitis, and even retinal necrosis. Up to 20% of affected patients develop post-herpetic neuralgia which can persist for years after the acute episode, resulting in potentially devastating consequences for the patient’s social, financial, and professional circumstances, as well as their quality of life and daily activities. Shingles prevention studies indicated that the herpes zoster vaccine markedly reduces the burden of the disease, as well as the incidence of both infection and post-herpetic neuralgia. Here we review the vaccinations available for herpes zoster, the reasons behind their limited adoption so far, as well as the future perspectives and challenges associated with this debilitating disease in the era of herpes zoster vaccination and coronavirus disease pandemic.

The reactivated form of the varicella-zoster virus (VZV) is responsible for chickenpox, known as herpes zoster (HZ). Although it is a self-limiting infection, it presents debilitating and painful mucosal and dermal vesicular eruptions. Early identification and management are vital to curbing the spread of HZ infection. In this extensive review, we present an overview of HZ, including its structure, pathophysiology, clinical presentation, complications, investigations, and management. Our review also highlights the prophylaxis and treatment of complications manifested by the VZV.

There are successful reports of the concomitant management of herpes infection and coronavirus disease 2019 (COVID-19), using both acyclovir (ACV) and COVID-19 treatment regimens. Furthermore, ACV has been proposed to effectively treat COVID-19, through various mechanisms, such as inhibition of viral proteases, multiple viral gene expressions, and RNA- dependent RNA polymerase (RdRP). Therefore, this study aimed to review the reported cases of patients with concomitant herpes infection and COVID-19, receiving concurrent antiviral drugs for herpetic lesions.

A search was done to find the relevant articles, published between December 2019 and December 2020, with no language limitations, in the PubMed database, using the Medical Subject Headings (MeSH) terms related to herpes simplex virus or herpes zoster (namely, shingles) combined with COVID-19. Accordingly, the reports of the concomitant herpes infection and COVID-19, receiving concurrent antiviral drugs for herpetic lesions were included.

Out of 90 articles, 11 records reporting the cases of herpes infection and concurrent laboratory-confirmed COVID-19, receiving antiherpetic therapies, were reviewed. There were 28 patients (age range of 7-82 years) with laboratory-confirmed COVID-19, concomitant with reactivation of herpes infection, receiving antiviral drugs alongside candidate COVID-19 treatment regimens, but no mortality. The mean (standard deviation [range]) age of these 28 patients during treatment was 56.4 (18.6 [7-82]) years, and the majority were male (n=18, 64.3%). A total number of 20 patients had also received ACV and eight cases had been administered with other two antiviral compounds, including seven cases with valacyclovir, and one case with famciclovir, with no mortality.

The potential use of ACV, as an add-on therapy, along with candidate COVID-19 treatment regimens was proposed in this study. However, further clinical trials are recommended to test this hypothetical adjuvant therapy.

Although 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is an established method for the staging of malignancies, benign lesions (e.g, active inflammatory lesions) often show increased metabolic activity. Herpes zoster is the clinical manifestation of the activation and replication of dormant varicella-zoster virus (VZV) in individuals with decreased cell-mediated immunity. Although the diagnosis of herpes zoster is clinical, it is sometimes observed incidentally during imaging for another disease. We describe the case of a 67-year-old Japanese female patient diagnosed with cervical cancer in whom FDG-PET/CT revealed herpes zoster manifestations: hypermetabolic cutaneous lesions in the buttock and pelvic lymph node involvement. The resected lymph nodes showed no malignant lesions but revealed lymphoid follicle formation, probably related to viral infection. There has been no report comparing FDG-PET findings of lymph nodes with histologic findings; the present findings are compatible with a clinically VZV-induced inflammatory reaction in regional lymph nodes, which increased FDG accumulation. Active infection with VZV displays increased FDG uptake in regional lymph nodes and may lead to incorrect malignant disease management in oncology. Misdiagnoses can be avoided by a careful interpretation by experienced nuclear medicine physicians as well as proper clinical evaluation.

Herpes zoster occurs due to reactivation of varicella zoster-virus (VZV) that is latent in dorsal root ganglion cells after primary varicella infection. It can occur in any age but is very rare during infancy. Acquisition of this virus in utero or early after birth may result in infantile herpes zoster.

Here, it is aimed to report an infant with herpes zoster whom his mother had developed varicella two years before pregnancy.

Despite the rarity of shingles in infants after birth, any infant who has a vesicular lesion in a particular neurological dermatome should be aware of the disease.

Varicella is a common and worldwide disease in childhood. It causes primary (chickenpox) and latent infection that may lead to a reactivation disease called zoster (shingles). Zoster or shingles is caused by reactivation of the virus that has been latent in the spinal dorsal ganglion and may occur even in immunocompetent hosts. Although zoster is rare in children, it may happen sometimes latter. The contemporaneous occurrence varicella and zoster are very rare. We present an immunocompetent 4 years old boy presented by simultaneous varicella and zoster after a household contact.In this case, the virus appeared both neurotropic and dermotropic characteristics simultaneously.  This study may enhance the awareness about this rare presentation and obviate the need for unnecessary ‎treatments and ‎investigations for both clinicians and patients‎.