Postherpetik Nevralji Tanısıyla Takip Edilen Hastaların Demografik ve Klinik Özelliklerinin Değerlendirilmesi
Öz
Herpes zoster varisellaya neden olan varisella zoster virüsünün reaktivasyonu nedeniyle oluşmaktadır. Postherpetik nevralji (PHN) herpes zosterin en sık görülen komplikasyonudur. Çalışmamızda PHN nedeniyle takip edilen hastaların demografik ve klinik verilerinin retrospektif olarak değerlendirilmesini amaçladık. Temmuz 2021-Temmuz 2022 tarihleri arasında üçüncü basamak bir hastanenin dermatoloji kliniğine başvuran PHN tanılı tüm hastalar arşivden taranarak demografik ve klinik özellikleri kaydedilmiştir. Çalışmamızda PHN tanılı hastaların çoğunun 60 yaş üzerinde olduğunu ve önemli kısmının komorbiditesinin olduğunu gözlemledik. En sık görülen komorbid hastalık diyabetes mellitus (%21.8) iken bunu sırasıyla hipertansiyon (%18.75), maligniteler (%15.6), kalp yetmezliği (%14) ve fibromyalji (%6) takip etmekteydi. Alınan ilaçlar değerlendirildiğinde en sık alınan tedavinin brivudin (%40.6) olduğu bunu valasiklovir (%37.5), intravenöz asiklovir (%10.9) ve oral asiklovirin (%3) takip ettiği görüldü. Dermatomal tutulumu değerlendirdiğimizde torakal dermatomların en sık etkilendiği (%48.4), bunu lomber, periorbital, sakral ve servikal dermatomların takip ettiği görüldü. Çalışmamızda dikkat çekici bir husus da bazı hastaların dermatoloji kliniklerine zonadan yıllar sonra bile başvurmalarıydı. Ayrıca bu çalışmamız ile zoster aşısının risk gruplarında yaygınlaştırılmasının önemine de dikkat çekmek istemekteyiz.
Anahtar Kelimeler
Kaynakça
- Bilen, A. (2020). Evaluation of patients with postherpetic neuralgia admitted to pain clinic. Klimik Dergisi, 33(1), 52-54.
- Forbes, H.J., Bhaskaran, K., Thomas, SL., Smeeth, L., Clayton, T., Mansfield, K., ... & Langan, SM. (2016a). Quantification of risk factors for postherpetic neuralgia in herpes zoster patients: A cohort study. Neurology, 87(1), 94-102.
- Forbes, H.J., Thomas, S.L., Smeeth, L., Clayton, T., Farmer, R., Bhaskaran, K., & Langan, S.M. (2016b). A systematic review and meta analysis of risk factors for postherpetic neuralgia. Pain, 157(1),30-54.
- Gauthier, A., Breuer, J., Carrington, D., Martin, M., & Rémy, V. (2009) Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect, 137(1):38-47.
- Gialloreti, L.E., Merito, M., Pezzotti, P., Naldi, L., Gatti, A., Beillat, M., ... & Volpi A. (2010). Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: a retrospective, population-based study. BMC Infect Dis, 10, 230.
- Jeon, Y.H. (2015). Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment. Korean J Pain, 28(3), 177-184.
- Jih, J.S., Chen, Y.J., Lin, M.W., Chen, Y.C., Chen, T.J., Huang, Y.L., ... & Liu HN. (2009). Epidemiological features and costs of herpes zoster in Taiwan: a national study 2000 to 2006. Acta Derm Venereol, 89(6), 612-616.
- Johnson, R.W., Wasner, G., Saddier, P., & Baron, R. (2007). Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother, 7(11), 1581-1595.
- Jones, M.R., Ehrhardt, K.P., Ripoll J.G., Sharma, B., Padnos, I.W., Kaye, R.J., & Kaye, A.D. (2016). Pain in the Elderly. Curr Pain Headache Rep, 20(4), 23.
- Kim, J.H. (2015). Risk factor and prevention of postherpetic neuralgia. The Korean Journal of Pain, 28(3), 167-168.
- Kost, R.G., & Straus, S.E. (1996). Postherpetic neuralgia--pathogenesis, treatment, and prevention. N Engl J Med, 335(1), 32-42.
- Lal, H., Cunningham, A.L., Godeaux, O., Chlibek, R., Diez-Domingo, J., Hwang, S.J., ... & Heineman, TC; ZOE-50 Study Group. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 28,372(22), 2087-2096.
- Lilie, H.M., & Wassilew, S. (2003). The role of antivirals in the management of neuropathic pain in the older patient with herpes zoster. Drugs Aging, 20(8), 561-570.
- Max, M.B., Schafer, S.C., Culnane, M., Smoller, B., Dubner, R., & Gracely, R.H. (1988). Amitriptyline, but not lorazepam, relieves postherpetic neuralgia. Neurology, 38(9), 1427-1432
- Opstelten, W., Mauritz, J.W., de Wit, N.J., van Wijck, A.J., Stalman, W.A., & van Essen, G.A. (2002). Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract, 2002, 19(5), 471-475.
- Parikh, R., Widenmaier, R. & Lecrenier, N. (2021). A practitioner's guide to the recombinant zoster vaccine: review of national vaccination recommendations. Expert Review of Vaccines, 20(9), 1065-1075.
- Saguil, A., Kane, S., Mercado, M., & Lauters, R. (2017). Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician, 96(10), 656-663.
- Tyring, S., Barbarash, R.A., Nahlik, J.E., Cunningham, A., Marley, J., Heng, M., ... & Saltzman, R. (1995). Famciclovir for the treatment of acute herpes zoster: effects on acute disease and postherpetic neuralgia. A randomized, double-blind, placebo-controlled trial. Collaborative Famciclovir Herpes Zoster Study Group. Ann Intern Med, 123(2), 89-96
- Utaş, S., & Akyol, D.T. (2002). Postherpetik nevralji ve tedavisi. Turkderm, 36(4), 298-302
- Wei, S., Li, X., Wang, H., Liu, Q., & Shao, L. (2019). Analysis of risk factors for postherpetic neuralgia. Dermatology, 235(5), 426-433.
- Wood, M.J., Balfour, H., Beutner, K., Bruxelle, J., Fiddian, P., Johnson, R., ... & Rentier B. (1995). How should zoster trials be conducted? J Antimicrob Chemother, 36(6), 1089-1101
Evaluation of Demographic and Clinical Characteristics of the Patients with the Diagnosis of Postherpetic Neuralgia
Öz
Herpes zoster is caused by reactivation of varicella zoster virus which causes varicella. Postherpetic neuralgia (PHN) is the most common complication of herpes zoster. We aimed to evaluate the demographic and clinical data of patients with PHN retrospectively. All the patients who applied to the dermatology clinic of a tertiary care hospital between July 2021 and July 2022 with the diagnosis of PHN were scanned from the archive and the demographic and clinical characteristics of the patients were recorded. In our study we observed that most of the patients with PHN were older than 60 years and significant number of patients had comorbidity. The most common comorbid disease was diabetes mellitus (21.8%), followed by hypertension (18.75%), malignities (15.6%), heat failure (14%) and fibromyalgia (6%) respectively. As respects the medications taken the most common treatment was brivudin (40.6%) followed by valaciclovir (37.5%), intravenous aciclovir (10.9%) and oral aciclovir (3%). We also evaluated the dermatomal involvement and thoracal dermatomas were most frequently affected (48.4%), followed by lomber, periorbital, sacral and servical dermatomas. A remarkable point in our study is that some of the patients applied to dermatology clinics even after years they had zoster. With this study we also want to emphasize the importance spreading the zoster vaccine to risk groups.
Anahtar Kelimeler
Kaynakça
- Bilen, A. (2020). Evaluation of patients with postherpetic neuralgia admitted to pain clinic. Klimik Dergisi, 33(1), 52-54.
- Forbes, H.J., Bhaskaran, K., Thomas, SL., Smeeth, L., Clayton, T., Mansfield, K., ... & Langan, SM. (2016a). Quantification of risk factors for postherpetic neuralgia in herpes zoster patients: A cohort study. Neurology, 87(1), 94-102.
- Forbes, H.J., Thomas, S.L., Smeeth, L., Clayton, T., Farmer, R., Bhaskaran, K., & Langan, S.M. (2016b). A systematic review and meta analysis of risk factors for postherpetic neuralgia. Pain, 157(1),30-54.
- Gauthier, A., Breuer, J., Carrington, D., Martin, M., & Rémy, V. (2009) Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect, 137(1):38-47.
- Gialloreti, L.E., Merito, M., Pezzotti, P., Naldi, L., Gatti, A., Beillat, M., ... & Volpi A. (2010). Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: a retrospective, population-based study. BMC Infect Dis, 10, 230.
- Jeon, Y.H. (2015). Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment. Korean J Pain, 28(3), 177-184.
- Jih, J.S., Chen, Y.J., Lin, M.W., Chen, Y.C., Chen, T.J., Huang, Y.L., ... & Liu HN. (2009). Epidemiological features and costs of herpes zoster in Taiwan: a national study 2000 to 2006. Acta Derm Venereol, 89(6), 612-616.
- Johnson, R.W., Wasner, G., Saddier, P., & Baron, R. (2007). Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother, 7(11), 1581-1595.
- Jones, M.R., Ehrhardt, K.P., Ripoll J.G., Sharma, B., Padnos, I.W., Kaye, R.J., & Kaye, A.D. (2016). Pain in the Elderly. Curr Pain Headache Rep, 20(4), 23.
- Kim, J.H. (2015). Risk factor and prevention of postherpetic neuralgia. The Korean Journal of Pain, 28(3), 167-168.
- Kost, R.G., & Straus, S.E. (1996). Postherpetic neuralgia--pathogenesis, treatment, and prevention. N Engl J Med, 335(1), 32-42.
- Lal, H., Cunningham, A.L., Godeaux, O., Chlibek, R., Diez-Domingo, J., Hwang, S.J., ... & Heineman, TC; ZOE-50 Study Group. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 28,372(22), 2087-2096.
- Lilie, H.M., & Wassilew, S. (2003). The role of antivirals in the management of neuropathic pain in the older patient with herpes zoster. Drugs Aging, 20(8), 561-570.
- Max, M.B., Schafer, S.C., Culnane, M., Smoller, B., Dubner, R., & Gracely, R.H. (1988). Amitriptyline, but not lorazepam, relieves postherpetic neuralgia. Neurology, 38(9), 1427-1432
- Opstelten, W., Mauritz, J.W., de Wit, N.J., van Wijck, A.J., Stalman, W.A., & van Essen, G.A. (2002). Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract, 2002, 19(5), 471-475.
- Parikh, R., Widenmaier, R. & Lecrenier, N. (2021). A practitioner's guide to the recombinant zoster vaccine: review of national vaccination recommendations. Expert Review of Vaccines, 20(9), 1065-1075.
- Saguil, A., Kane, S., Mercado, M., & Lauters, R. (2017). Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician, 96(10), 656-663.
- Tyring, S., Barbarash, R.A., Nahlik, J.E., Cunningham, A., Marley, J., Heng, M., ... & Saltzman, R. (1995). Famciclovir for the treatment of acute herpes zoster: effects on acute disease and postherpetic neuralgia. A randomized, double-blind, placebo-controlled trial. Collaborative Famciclovir Herpes Zoster Study Group. Ann Intern Med, 123(2), 89-96
- Utaş, S., & Akyol, D.T. (2002). Postherpetik nevralji ve tedavisi. Turkderm, 36(4), 298-302
- Wei, S., Li, X., Wang, H., Liu, Q., & Shao, L. (2019). Analysis of risk factors for postherpetic neuralgia. Dermatology, 235(5), 426-433.
- Wood, M.J., Balfour, H., Beutner, K., Bruxelle, J., Fiddian, P., Johnson, R., ... & Rentier B. (1995). How should zoster trials be conducted? J Antimicrob Chemother, 36(6), 1089-1101
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023Cilt: 8 Sayı: 2 |
