Clinical features of herpes zoster according to immune state

Background: Varicella zoster virus (VZV) can be reactivated as a consequence of declining VZV-specific cellular immunity, leading to herpes zoster. Objective: The purpose of this study was to compare the clinical features of herpes zoster according to immune state. Methods: We classified 343 cases of herpes zoster into three groups, according to the presence of underlying disease and immune state; immunocompetent state without underlying disease (Group A), immunocompetent state with underlying disease (Group B), immunocompromised state (Group C). We compared the distribution of age, sex, season and dermatome, severity of skin lesion and pain, and the incidence of postherpetic neuralgia among these groups. Results: 1. There was a significant difference between group A and B in age distribution. 2. The ratio of male to female, seasonal distribution and severity of skin lesion were not significantly different among the three groups. 3. The incidence of trigeminal involvement was significantly, higher in group A and B with statistical significance, while that of thoracic involvement was higher in group C. 4. The percentage of severe pain was significantly higher in group B than in group C. However, the rate of pain relief was not significantly different among the three groups. 5. The incidence of postherpetic neuralgia was not significantly different. Conclusion: It is suggested that immune state may significantly influence the clinical features, such as distribution of age, dermatome and severity of pain in herpes zoster.