Petursson G, Helgason S, Gudmundsson S, Sigurdsson J A
Department of Family Medicine, University of Iceland, Reykjavik.
Pediatr Infect Dis J. 1998 Oct;17(10):905-8. doi: 10.1097/00006454-199810000-00011.
To follow the clinical course of herpes zoster and to determine the incidence, frequency of complications and association with malignancy in children and adolescents.
Prospective cohort study in a primary health care setting in Iceland. The main outcome measures were age and sex distribution of patients and discomfort or pain 1, 3 and 12 months after the rash and general health before and 3 to 6 years after the zoster episode.
During observation of the target population for a period of 75750 person years, 121 episodes of acute zoster developed (incidence 1.6/1000/year) in 118 patients. End points were gained for all 118 patients after 554 person years of follow-up. Systemic acyclovir was never used. No patient developed postherpetic neuralgia, moderate or severe pain or any pain lasting longer than 1 month from start of the rash (95% confidence interval, 0 to 0.03). Potential immunomodulating conditions were diagnosed in 3 patients (2.5%) within 3 months of contracting zoster. Only 5 (4%) had a history of severe diseases.
The probability of postherpetic neuralgia in children and adolescents is extremely low. Zoster is seldom associated with undiagnosed malignancy in the primary care setting.
追踪带状疱疹的临床病程，确定儿童和青少年带状疱疹的发病率、并发症发生率以及与恶性肿瘤的关联。
在冰岛的一个初级卫生保健机构进行的前瞻性队列研究。主要观察指标为患者的年龄和性别分布，以及出疹后1个月、3个月和12个月时的不适或疼痛情况，还有带状疱疹发作前以及发作后3至6年的总体健康状况。
在对目标人群进行为期75750人年的观察期间，118例患者出现了121次急性带状疱疹发作（发病率为1.6/1000/年）。经过554人年的随访，所有118例患者均获得了观察终点。从未使用过全身性阿昔洛韦。没有患者发生带状疱疹后神经痛、中度或重度疼痛，也没有任何疼痛从出疹开始持续超过1个月（95%置信区间为0至0.03）。在感染带状疱疹后3个月内，3例患者（2.5%）被诊断出可能存在免疫调节异常情况。只有5例（4%）有严重疾病史。
儿童和青少年发生带状疱疹后神经痛的可能性极低。在初级保健环境中，带状疱疹很少与未确诊的恶性肿瘤相关。
