The Clinical Features of Herpes Zoster Ophthalmicus in Inpatients / 대한피부과학회지

ABSTRACT

BACKGROUND: There have been many studies about herpes zoster in the Korean dermatologic literature. However, few studies have reported on herpes zoster ophthalmicus, and especially in inpatients. OBJECTIVE: The purpose of this study was to investigate the clinical features of herpes zoster ophthalmicus in inpatients. Methods: During an 8-year-period from January 2000 to December 2008, 130 patients with herpes zoster ophthalmicus were evaluated in regard to the annual, monthly and seasonal incidences, the age incidence and the gender ratio. The patients with herpes zoster ophthalmicus were further assessed concerning the dermatomic distributions, the associated diseases and their complications. RESULTS: The averaged annual incidence over the eight years was 8.7% out of the total 1,496 inpatients. The male to female ratio was 11.1. There were no marked seasonal variations. Among the age groups, the incidence rate was highest in the seventh decade (25.4%). The dermatomal distribution was the ophthalmic branch of the trigeminal nerve (93.1%), followed by the ophthalmic and maxillary branches of the trigeminal nerve (6.2%) and a generalized distribution (0.7%). The frequency of associated diseases was in descending order hypertension, diabetes mellitus, gastric ulcer and malignancy. The most common complication of herpes zoster ophthalmicus was ocular complication (70.8%), followed by postherpetic neuralgia (50%). Ocular complications were observed in 92 patients (70.8%), and these complications included conjunctivitis (62.3%), keratitis (26.9%), uveitis (10.0%), scleritis (1.5%) and glaucoma (1.5%). The frequency and severity of ocular complication were higher in the patients with Hutchinson's sign (p<0.05). CONCLUSION: Herpes zoster ophthalmicus is associated with substantial ocular complications and postherpetic neuralgia. Therefore, patients with herpes zoster ophthalmicus (and especially those with Hutchinson's sign) should receive immediate antiviral therapy and ophthalmologic consultation.