Department of Dermatology, Geisinger Health System-Scenery Park, 200 Scenery Dr, 56-02, State College, PA, 16801, USA.
Am J Clin Dermatol. 2020 Feb;21(1):97-107. doi: 10.1007/s40257-019-00483-1.
Herpes zoster (HZ) is a common cutaneous entity with protean clinical presentations, management options, complication rates, and prevention strategies, all of which are rife with dogma. During an inpatient consultation for HZ, have you ever been approached by a frantic staff or family member, worried that a pregnant, elderly, or infant contact will be 'infected' if they get too close? Have your patients ever asked you about their risk of having HZ twice, or claimed that they have frequent 'recurrences'? In what timeline should antiviral therapy be employed? Is there evidence for prednisone or gabapentin in acute HZ treatment? Who should be vaccinated against HZ and what are the benefits and risks? In case-based form, these and other complex but common scenarios will be examined using clinical and viral mechanistic clues, along with updated treatment and prevention guidelines, to provide a modern HZ case management compendium, comprehensive of the diverse age and health populations now presenting with this condition.
带状疱疹(HZ)是一种常见的皮肤疾病,其临床表现多样,治疗选择多样,并发症发生率高,预防策略多样,所有这些都充斥着各种定论。在 HZ 的住院咨询中,你是否曾被焦急的医护人员或家属询问,担心孕妇、老年人或婴儿如果靠得太近会“被感染”?你的患者是否曾询问过他们两次患 HZ 的风险,或声称他们经常“复发”?抗病毒治疗应该在什么时候进行?泼尼松或加巴喷丁在急性 HZ 治疗中有证据支持吗?哪些人应该接种 HZ 疫苗,以及接种的好处和风险是什么?通过案例形式,将使用临床和病毒机制线索以及最新的治疗和预防指南来检查这些以及其他复杂但常见的情况,为现代 HZ 病例管理提供综合指南,涵盖现在出现这种情况的不同年龄和健康人群。