Natural history and treatment of herpes zoster.

Journal Article (Journal Article;Review)

UNLABELLED: The objective of this article is to provide an overview of the natural history and treatment of herpes zoster, with a focus on pain management. Herpes zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of herpes zoster is a marked increase in incidence with aging and with diseases and drugs that impair cellular immunity. Herpes zoster begins with reactivation of varicella zoster virus in dorsal root or cranial nerve ganglia, which is often accompanied by a prodrome of dermatomal pain or abnormal sensations. Varicella zoster virus spreads in the affected primary afferent nerve to the skin and produces a characteristic dermatomal maculopapular and vesicular rash and pain. Herpes zoster acute pain lowers quality of life and interferes with activities of daily living. Antiviral therapy and scheduled analgesics form the pharmacotherapeutic foundation for herpes zoster acute pain reduction. If moderate to severe herpes zoster pain is not adequately relieved by antiviral agents in combination with oral analgesic medications, then corticosteroids, anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg, nortriptyline or desipramine), or neural blockade can be considered. PERSPECTIVE: This article presents information on the clinical features and treatment of herpes zoster. This information will help clinicians diagnose and manage herpes zoster pain.

Full Text

Duke Authors

Cited Authors

  • Schmader, KE; Dworkin, RH

Published Date

  • January 2008

Published In

Volume / Issue

  • 9 / 1 Suppl 1

Start / End Page

  • S3 - S9

PubMed ID

  • 18166460

International Standard Serial Number (ISSN)

  • 1526-5900

Digital Object Identifier (DOI)

  • 10.1016/j.jpain.2007.10.002


  • eng

Conference Location

  • United States