• The Korean Journal of Pain
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• v.24 no.2
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• pp.108-111
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• 2011

Herpes zoster as a result of reactivated varicella-zoster virus is characterized by vesicular eruptions on skin and painful neuralgia in the dermatome distribution. Pain during an acute phase of herpes zoster has been associated with a higher risk of developing postherpetic neuralgia. The current therapies for herpes zoster including analgesics and sympathetic nerve block as well as antiviral agents are important to alleviate pain and prevent postherpetic neuralgia. However, in some cases, the pain does not respond well to these treatments. We had a case in which a patient with herpes zoster did not respond to conventional therapy so we attempted to administer intravenous infusion of vitamin C which resulted in an immediate reduction in the pain.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.183-187
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• 1999

Background: The efficacy of nerve block on the progression of herpes zoster still remains controversy. The purpose of this study was to evaluate the efficacy of epidural blockade on the pain course of acute herpes zoster. Methods: Among 75 patients admitted with acute herpes zoster, 40 patients were treated with acyclovir and epidural block (epidural group), 35 patients were treated with acyclovir only (no block group). Follow up with patients was done for up to 3 months, either at the outpatient department or by telephone. The days required for pain relief were compared. We also investigated the factors associated with outcome. Results: Though statistically insignificant, patients in the epidural group tended to have faster pain relief. Patients with shorter symptom duration experienced significantly faster pain relief. But other factors such as sex, age, involved dermatome and other coexisting diseases (cancer, diabetes mellitus) were not associated with the outcome in this study. Conclusions: Though patients with epidural block leaded to have taster pair relief, more studies with larger patient population may be needed to confirm the efficacy of epidural block on herpes zoster.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.210-213
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• 2005

Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

• Journal of the Korea Convergence Society
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• v.12 no.8
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• pp.327-333
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• 2021

Zoster-associated pain (ZAP) in patients with herpes zoster (HZ) may persist for a long time, occurring even years after the rash has healed. In this case, the patient is diagnosed as having postherpetic neuralgia (PHN). Prodromal symptoms can present with constant or intermittent pain, and are often accompanied by other symptoms, resulting in misdiagnosis and/or inappropriate treatment. The aim of this study is to investigate the characteristics of the prodromal symptoms of ZAP through a multicenter study in Korea.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.4-10
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• 2023

Herpes zoster (HZ) is a common disease in the aging population and immunocompromised individuals, with a lifetime risk of 20%-30% that increases with age. HZ is caused by reactivation of the varicella-zoster virus (VZV), which remains latent in the spinal dorsal root ganglia and cranial sensory ganglia after resolution of the primary VZV infection. The main focus of HZ management is rapid recovery from VZV infection as well as the reduction and prevention of zoster-associated pain (ZAP) and postherpetic neuralgia (PHN). The use of antivirals against VZV is essential in the treatment of HZ. However, limited antivirals are only licensed clinically for the treatment of HZ, including acyclovir, valacyclovir, famciclovir, brivudine, and amenamevir. Fortunately, some new antivirals against different types of Herpesviridae have been investigated and suggested as novel drugs against VZV. Therefore, this review focuses on discussing the difference in efficacy and safety in the currently licensed antivirals for the treatment of HZ, the applicability of future novel antivirals against VZV, and the preventive or therapeutic effects of these antivirals on ZAP or PHN.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.229-231
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• 2005

The most common and cumbersome complication of herpes zoster is postherpetic neuralgia, which typically presents as neuropathic pain. However, the painful symptoms of the postherpetic period might be associated with other causes, such as skin lesions of the herpes zoster. We report a case of a hypertrophic scar that developed in the lesion of an acute herpes zoster patient and was accompanied by pain.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.205-212
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• 2007

Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.52-56
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• 2005

Herpes zoster (HZ) is an acute infection of the unilateral sensory dermatome caused by varicella-zoster virus (VZV) and is characterized by vesicular eruption and unilateral pain along the involved dermatome. Although the pathogenesis of HZ is incompletely understood, it is thought that when cell-mediated immunity falls below a critical level, dormant VZV within cells of the sensory ganglia are allowed to replicate and infect the host with the resultant clinical presentation of HZ. It has been associated with immunosuppressed states, such as advanced age, leukemia, lymphoma, chemotherapy and/or radiation treatment. We present a case of a 62-year-old female patient with malignant lymphoma suffering herpes zoster ophthalmicus who did not respond to conventional treatment, and in whom the application of various nerve blocks and patient-controlled analgesia produced moderate pain relief. The patient died twenty days later due to cardiopulmonary failure.

• The Korean Journal of Pain
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• v.28 no.3
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• pp.177-184
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• 2015

Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.2
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• pp.125-133
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• 2001

Herpes Zoster Oticus is a reactivation of latent varicella-zoster infection associated otalgia, facial nerve palsy, sensorineural hearing loss and vertigo. Facial nerve palsy is rapid in onset, usually severe degree, and poor is prognosis. And pain in the form of acute neuritis and postherpetic neuralgia is by far the most frequent and most debilitating complication of Herpes Zoster. The pain of Herpes Zoster may severe, but it is usually transitory. Some patients, with the elderly at particular risk, go on to develop postherpetic neuralgia. In the two cases, pain (especially postherpetic neuralgia) which is often severe and, unfortunately, refractory to most forms of treatment was reduced using herbal medicine and acupuncture but facial nerve palsy was not improved.