Marahatta Suchana, Jha Shivendra Kumar, Ghimire Ashish
Department of Dermatology & Venereology, B. P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal.
Department of Dermatology and Venerology, Sukraraj Tropical and Infectious Diseases Hospital (STIDH), Teku, Kathmandu, Nepal.
J Cosmet Dermatol. 2025 Apr;24(4):e70136. doi: 10.1111/jocd.70136.
Herpes zoster (HZ) is a viral infection with severe acute and chronic pain. This study was aimed at determining the incidence rate of postherpetic neuralgia (PHN). The objectives of the study were to understand the epidemiology of HZ and to identify the risk factors for PHN at a referral hospital in eastern Nepal.
A total of 82 patients with HZ presenting within 72 h of skin eruption with a pain rating of 40 or above on a visual analog scale, with an age ≤ 75 years and those willing to participate were included in the study. However, those who had already started antiviral medicine or analgesics were excluded. All baseline details were noted and the participants were followed for 16 weeks at monthly intervals to assess the pain status and development of PHN. The epidemiological parameters and the predictors of PHN were predicted using the chi-square test and logistic regression analysis.
The mean age of the participants was 47 ± 18.77 years. The majority (32.9%) of the participants belonged to 61-70 years. Thoracic dermatome was most frequently (56.1%) involved. At the 16-week follow-up, of the 77 patients who completed the study, 14 had persistent pain; hence, the incidence of PHN was 18.2%. Advancing age (> 50 years) (adjusted odds ratio 2.95, 95% confidence interval (CI) 1.33-6.53); diabetes (OR 13.09, 95% CI 1.40-122.24); and prolonged prodromal pain (OR 12.01, 95% CI 1.40-102.77) were the most important risk factors for PHN.
In our study, the prevalence of PHN was quite high (18.2%) despite timely antiviral treatment and regular follow-up. An age of more than 50 years, prolonged prodromal pain, and diabetes were the most significant predictors of PHN. Hence, early intervention and frequent follow-up of those individuals are recommended.
带状疱疹（HZ）是一种伴有严重急慢性疼痛的病毒感染。本研究旨在确定带状疱疹后神经痛（PHN）的发病率。该研究的目的是了解尼泊尔东部一家转诊医院中HZ的流行病学情况，并确定PHN的危险因素。
共有82例HZ患者纳入本研究，这些患者在皮疹出现72小时内就诊，视觉模拟评分法疼痛评分在40分及以上，年龄≤75岁且愿意参与研究。然而，那些已经开始使用抗病毒药物或镇痛药的患者被排除在外。记录所有基线细节，并对参与者每月随访16周，以评估疼痛状况和PHN的发生情况。使用卡方检验和逻辑回归分析预测PHN的流行病学参数和预测因素。
参与者的平均年龄为47±18.77岁。大多数（32.9%）参与者年龄在61 - 70岁之间。胸段皮节受累最为常见（56.1%）。在16周的随访中，完成研究的77例患者中，有14例持续疼痛；因此，PHN的发病率为18.2%。年龄增长（>50岁）（调整后的优势比为2.95，95%置信区间（CI）为1.33 - 6.53）；糖尿病（优势比为13.09，95%CI为1.40 - 122.24）；以及前驱疼痛持续时间延长（优势比为12.01，95%CI为1.40 - 102.77）是PHN最重要的危险因素。
在我们的研究中，尽管进行了及时的抗病毒治疗和定期随访，但PHN的患病率仍然相当高（18.2%）。年龄超过50岁、前驱疼痛持续时间延长和糖尿病是PHN最显著的预测因素。因此，建议对这些个体进行早期干预和频繁随访。
