A Clinico-Epidemiological Study of Herpes Zoster in a Tertiary Care Center in Srikakulam District, Andhra Pradesh, India

Abstract

Introduction: Herpes zoster, popularly known as shingles, is caused by the "Varicella zoster virus," a latent neurotrophic virus, reactivating in the dorsal root ganglion. The terms "zoster" or "girdle" depict the disease's segmental spread. It results in segmental cutaneous eruption in people who have experienced clinically or subclinically active varicella infection in the past. Aims and Objective: To study the various clinico-morphological presentations of herpes zoster and to know the epidemiological factor determining herpes zoster. Materials and methods: It's a cross sectional, observational study. Patients with clinical diagnosis of herpes zoster presenting to the outpatient department of Dermatology, Venereology and Leprosy, during the period of December 2021 to November 2022 at GEMS & Hospital, Ragolu, Srikakulam were taken. After taking consent, patients of all ages and genders with a clinical diagnosis of herpes zoster were included. Patients with complicated herpes zoster I. e with visceral involvement,pregnant and lactating females were excluded. A thorough epidemiological and clinical history was taken. The characteristic presentation of vesicles in a dermatomal or disseminated pattern confirmed the clinical diagnosis of herpes zoster. Whenever necessary, Tzanck smears were performed. Results: A total of 100 patients were taken in the study. The number of males were 52 and females were 48 with a male : female ratio of 1. 08 : 1. Most commonly affected age group was 31-40 years i. e 33 patients. 38% patients presented within 72 hours of appearance of cutaneous lesions. 82% patients had prodromal symptoms before onset of cutaneous lesions. The most common prodromal symptom was pain 2 days before the onset of lesions at that site of onset of lesions in 45% patients followed by fever in 13% patients. 76% of patients have other associated conditions, in which diabetes was the most common comorbidity observed in 38%. Past history of varicella was noted in 79% of patients. Grouped vesicles with erythematous background in dermatomal distribution were present in 97% of patients. Thoracic dermatome was the most common dermatome involved in 62% patients followed by lumbar 9%. Multidermatomal involvement was predominantly seen in immunocompromised patients and older age groups. In hemogram, 6 patients had eosinophilia, 11 patients had elevated serum glucose levels, urinalysis shows reduced sugars in 4 patients. Conclusion : According to this study, the third or fourth decade of life is when herpes zoster typically manifests. The most frequent site of involvement is the thoracic dermatome. Early diagnosis and antiviral medication can lessen the severity, complications, and postherpetic neuralgia, especially in older and immunocompromised patients.