Actualización de las recomendaciones de vacunación en adultos con enfermedades respiratorias. Documento de la Asociación Argentina de Medicina Respiratoria para los neumonólogos, 2023 / Recommendations in Adults with Respiratory Diseases. Document from the Argentinian Association of Respiratory Medicine for Pulmonologists, 2023

RESUMEN Los adultos fumadores, con comorbilidades, y los ancianos tienen mayor riesgo de contraer infecciones pulmonares y de tener peor evolución. La neumonía adquirida en la comunidad debida a virus, neumococo, además de otras bacterias y microorga nismos "atípicos" afecta tanto a adultos sanos como enfermos. La vacuna antigripal se diseña el verano anterior orientada a las cepas esperadas para la temporada siguiente. Su eficacia depende fundamentalmente de la variante viral que finalmente sea la responsable del brote. La vacuna anti-neumocócica polisacárida existe desde 1983 y será inexorablemente reemplazada por vacunas conjugadas de mayor eficacia, que previenen la infección por los serotipos presentes en la vacuna. La inmunización contra SARS-CoV-2 aceleró la reducción del contagio y la gravedad de COVID-19 notablemente. La vacuna acelular para Bordetella pertussis no está en el calendario de adultos, aun cuando vacunarlos fortalece el control del contagio infantil. La vacunas doble bacteriana (difteria y tétanos), y triple (doble + pertusis), y contra sarampión, varicela, rubeola, HPV, Haemophylus influenzae, meningococo, herpes zóster, fiebre hemorrágica argentina y fiebre amarilla están disponibles, pero son de uso limitado. Nuevas vacunas, como la recientemente aprobada por los CDC contra el virus sincicial respiratorio, pronto estarán disponibles.

ABSTRACT Adult smokers, subjects with comorbidities, and the elderly are at higher risk of pulmo nary infections and worse outcomes. Community-acquired pneumonia due to viruses, pneumococcus, other bacteria, and "atypical" microorganisms affects healthy and sick adults. The flu vaccine is designed the previous summer for the strains expected for the following season. Its effectiveness depends fundamentally on the viral variant ultimately responsible for the outbreak. The anti-pneumococcal polysaccharide vaccine has been available since 1983 and it is expected to be replaced by conjugate vaccines which are more effective in preventing infection due to serotypes present in the vaccine. Immuniza tion against SARS-CoV-2 diminished contagion and severity of COVID-19 remarkably. The acellular vaccine for Bordetella pertussis is not on the schedule for all adults, even when vaccinating them strengthens the control of contagion in children. Double bacterial (diphtheria and tetanus), triple (double + pertussis), measles, varicella, rubella, HPV, Haemophilus influenzae, meningococcal, herpes zoster, Argentine hemorrhagic fever, and yellow fever vaccines are available, but their use is limited. New vaccines such as the one recently approved by the CDC against respiratory syncytial virus will soon be available.

Left mandibular osteonecrosis following herpes zoster of the third branch of left trigeminal nerve:A case report / 北京大学学报(医学版)

Herpes zoster of trigeminal nerve was a common skin disease caused by varicella-zoster virus infection.Simple involvement of the third branch of trigeminal nerve was rare,and so were oral complica-tions such as pulpitis,periodontitis,spontaneous tooth loss,bone necrosis,etc.This article presented a case of herpes zoster on the third branch of the left trigeminal nerve complicated with left mandibular osteonecrosis.We reported the case of a 64-year-old man with sudden pain in the left half of the tongue 1 month ago,and then herpes on the left facial skin appeared following with acute pain.The local hospital diagnosed it as herpes zoster and treated it with external medication.A few days later,he developed gum pain in the left mandibular posterior tooth area.He was admitted to Peking University School and Hospital of Stomatology one week ago with loose and dislodged left posterior tooth accompanied by left mandibular bone surface exposure.Clinical examination showed bilateral symmetry and no obvious restriction of mouth opening.Visible herpes zoster pigmentation and scarring on the left side of the face appeared.The left mandibular posterior tooth was missing,the exposed bone surface was about 1.5 cm x0.8 cm,and the surrounding gingiva was red and swollen,painful under pressure,with no discharge of pus.The re-maining teeth in the mouth were all m degree loosened.Imageological examination showed irregular low-density destruction of the left mandible bone,unclear boundary,and severe resorption of alveolar bone.The patient was diagnosed as left mandibular osteonecrosis.Under general anesthesia,left mandibular le-sion exploration and curettage+left mandibular partial resection+adjacent flap transfer repair were performed.The patient was re-exmained 6 months after surgery,there was no redness,swelling or other abnormality in the gums and the herpes pigmentation on the left face was significantly reduced.Unfortu-nately,the patient had complications of postherpetic neuralgia.This case indicate that clinicians should improve their awareness of jaw necrosis,a serious oral complication of trigeminal zoster,and provide ear-ly treatment.After the inflammation was initially controlled,surgical treatment could be considered to remove the necrotic bone,curettage the inflammatory granulation tissue,and extraction of the focal teeth to avoid further deterioration of the disease.

Cellular and cytokine immune responses during varicella zoster virus reactivation of herpes zoster infection / 西安交通大学学报(医学版)

Objective To study changes in immune cells and cytokines during the reactivation stage of varicella-zoster virus(VZV)in patients with herpes zoster.Methods A total of 50 patients with herpes zoster and 30 healthy individuals were selected from Xi'an Ninth Hospital between May 2022 and October 2022.Flow cytometry was used to detect the proportion of peripheral blood CD3+cells,CD4+cells,CD8+T cells,B cells and NK cells,as well as levels of cytokines IL-2,IFN-γ,IL-10 and IL-6.We analyzed the immune mechanism of VZV reactivation stage in herpes zoster patients.Results Compared with the healthy control group,the proportion of CD3+cells and CD4+T cells in herpes zoster patients decreased significantly;the proportion of NK cells significantly increased;the levels of IFN-γ,IL-10 and IL-6 significantly increased;the proportion of CD8+T cells,B cells and IL-2 content showed an increasing trend,but there was no significant difference.In addition,the severity of neurological involvement in herpes zoster patients might affect changes in cytokine levels.Conclusion During the reactivation period of VZV,changes in the proportion of immune cells and cytokine expression levels are closely related to the occurrence and development of herpes zoster.

Research progress on association between chronic diseases and herpes zoster / 中华全科医师杂志

Herpes zoster is an infectious skin disease caused by reactivation of the varicella-zoster virus with multiple manifestations and various complication clinically. Studies have confirmed that chronic diseases are one of the independent risk factors for HZ; and the common chronic diseases such as diabetes, cardiovascular disease, chronic obstructive pulmonary disease and rheumatoid arthritis are associated with the development of herpes zoster. In this article, we review the latest research progress on the clinical features of herpes zoster, its correlation with common chronic diseases and the prevention strategies to reduce the disease burden.

Task force of the Brazilian Society of Otology — evaluation and management of peripheral facial palsy

Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy.

Coronavirus disease 19 (COVID-19) and viral keratouveitis – unraveling the mystery

To demonstrate viral proteins/inflammatory cytokines in a patient with unilateral keratouveitis. Retrospective case report. A 70-year-old Asian-Indian male presented with acute onset of blurring of vision in the left eye (OS) of 2 days duration. He had was coronavirus disease 2019 (COVID-19)-positive 3 months earlier. He had undergone cataract surgery/retinal laser photocoagulation in both the eyes. The corrected distance visual acuity (CDVA) (Snellen) in the right eye (RE) (OD) and left eye (LE) (OS) was 20/20 and 20/80, respectively. OS showed decreased corneal sensation, Descemet’s folds, mild stromal edema, and fine and pigmented keratic precipitates with anterior chamber 1+ flare and 1+ cells. Fundus evaluation showed scattered laser marks in the OD and temporal sectoral laser marks in OS. He was diagnosed with viral keratouveitis in OS. Tear samples were collected on Schirmer’s strips and tear wash for mass spectrometry and cytokines, which had 368 and 451 viral proteins in the RE and LE, respectively, using nano liquid chromatography–mass spectrometry, which were more than controls. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and varicella zoster virus proteins were detected. Cytokine analysis using flow cytometer analysis showed higher inflammation in OS as compared to OD. The patient was treated with oral acyclovir and topical steroids and resulted in resolution of his keratouveitis. SARS-CoV-2 proteins were present in the tear sample 3 months after COVID-19. The presence of viral proteins does not indicate causality

Rehabilitación protésica en defecto ocular provocado por herpes zóster / Prosthetic Rehabilitation in Ocular Defect Caused by Herpes Zoster

El herpes zóster es el cuadro clínico constituido por las manifestaciones dermatológicas (erupción vesiculosa) y neurológica (dolor). Es la expresión de la recurrencia del virus varicela-zóster latente en los ganglios sensitivos, su aparición se favorece por el envejecimiento y la inmunosupresión con una prevalencia que se estima en un 20 %. Se describe los pasos clínicos para la confección de una prótesis ocular en el mejoramiento estético a un paciente con defecto ocular en ojo izquierdo provocado por herpes zoster. Se trata de un paciente masculino de piel blanca de 50 años de edad, que acudió a la consulta de prótesis del Policlínico Universitario Julio Antonio Mella de la provincia Camagüey remitido del Servicio de Oculoplastia del Hospital Universitario Manuel Ascunce Domenech con diagnóstico de defecto ocular izquierdo por evisceración como consecuencias de infección por herpes zoster y antecedente de inmunodepresión. El paciente expuso que la pérdida ocular fue por las complicaciones que se fueron sucediendo en la medida que se agravó su cuadro clínico. Además, refirió que presentaba dolor en la zona y que le irradiaba a la cabeza y que le preocupaba su estética. Se determinó la elaboración de una prótesis ocular acrílica para mejorar el aspecto estético, lo cual permitió que el paciente mejorara su autoestima y calidad de vida(AU)

Herpes zoster is the clinical picture constituted by dermatological (vesicular rash) and neurological (pain) manifestations. It is the expression of the recurrence of the latent varicella-zoster virus in the sensitive ganglia, its appearance is favored by aging and immunosuppression with a prevalence estimated at 20%. We describe the clinical steps for the fabrication of an ocular prosthesis for the aesthetic improvement of a patient with ocular defect in the left eye caused by herpes zoster. This is a 50-year-old male patient with white skin, who came to the prosthesis consultation of the Julio Antonio Mella University Polyclinic in Camagüey province, referred from the Oculoplasty Service of the Manuel Ascunce Domenech University Hospital with a diagnosis of left ocular defect due to evisceration as a consequence of herpes zoster infection and a history of immunosuppression. The patient explained that the ocular loss was due to the complications that occurred as his clinical condition worsened. In addition, he reported that he had pain in the area that radiated to the head and that he was concerned about his esthetics. It was decided to make an acrylic ocular prosthesis to improve the esthetic aspect, which allowed the patient to improve his self-esteem and quality of life(AU)

Pole-to-pole involvement of varicella zoster virus reactivation following COVID-19 vaccination

The aim of this study is to report the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management outcomes in a series of three cases of varicella zoster virus (VZV) reactivation following one dose of coronavirus disease 2019 (COVID-19) vaccination. This was a retrospective and observational study. All the patients who developed uveitis post-vaccination were pooled together. Patients who had VZV reactivation were included. Two cases had polymerase chain reaction positive for VZV from aqueous humor. At the time of presentation, IgG and IgM spike protein antibodies for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were tested. Out of this pool, three patients with classical features to describe pole-to-pole manifestations were chosen. A 36-year-old lady with post-vaccination sclerokeratouveitis associated with reactivation of herpes zoster ophthalmicus, a 56-year-old lady with post-vaccination acute anterior uveitis associated with herpes zoster ophthalmicus, and a 43-year-old gentleman with post-vaccination acute retinal necrosis were included. We present a possible link between anti-SARS-CoV-2 virus vaccination and varicella zoster reactivation in these patients and also describe the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management with detailed discussion.

Serum interleukin-6 levels are increased in post-herpetic neuralgia: a single-center retrospective study

Abstract Background: Studies have shown that the overall incidence rate of herpeszoster (HZ) in China is 6.64 cases per 1000 people, despite such harms brought by postherpetic neuralgia (PHN), the mechanism of the disease remains unclear in China. Currently, effective biomarkers to predict PHN remain unavailable, which makes it difficult to prevent and successfully treat PHN. Objectives: The aim of the study was to determine the serum interleukin-6 level in PHN. Methods: The serum levels of interleukin 6 (IL-6) were measured by multi-antibody sandwich ELISA. The likert scale was used to represent the degree of neuralgia in the patients. Patients with PHN were divided into a mild PHN group and a severe PHN group according to the Likert scale. ROC curve was performed for evaluating the diagnostic efficiency of IL6 for PHN. The correlation between the IL6 level and the Likert scale before and after treatment with gabapentin and mecobalamin was analyzed. Results: IL6 levels in PHN patients resulted higher compared to volunteers. Patients in the severe PHN group had a higher serum IL6 level than in the mild PHN group. The Likert scale score was related to the serum IL6 levels and the frequency of IL6 levels above the cutoff value (4.95pg/mL) in PNH groups before and after treatment (p<0.05). Study limitations: Pain is subjective. Some mental states, such as anxiety and depression, greatly influence an individual's perception of pain, and pain tolerance can vary between people. Therefore, pain scores can be affected by different individual factors. Conclusions: The serum IL6 levels may be used as a biochemical indicator of the severity of PNH.

Zoster sine herpete después de infección leve por SARS-CoV-2 / Zoster sine herpete after mild SARS-CoV-2 infection

El SARS-CoV-2 es un virus de afectación sistémica que impacta con gran intensidad en el sistema inmunológico; esto permite que virus de naturaleza latente, como el virus de Varicela Zoster (VVZ), tengan oportunidad de reactivarse y agravar el cuadro respiratorio con afectaciones cutáneas, mucosas y neurológicas. Se presenta un caso de Zoster sine herpete, durante la convalecencia del SARS-CoV-2, en un paciente masculino de 43 años, que acudió a consulta por dolor precordial de gran intensidad, sensación de escozor en tórax posterior y dificultad respiratoria; 10 días después de prueba de hisopado nasofaríngeo positiva para antígeno de SARS-CoV-2. Es importante no olvidar la probabilidad de presentaciones atípicas de virus latentes con el fin de realizar un diagnóstico y tratamiento oportuno a los pacientes.

SARS-CoV-2 is a systemic virus that has a strong impact on the immune system; this allows latent viruses, such as varicella-zoster virus (VZV), to reactivate and aggravate the respiratory symptoms with cutaneous, mucosal and neurological involvement. We present a case of Zoster sine herpete, during convalescence from SARS-CoV-2, in a 43-year-old male patient who presented with severe precordial pain, stinging sensation in the posterior thorax and respiratory distress; 10 days after a positive nasopharyngeal swab test for SARS-CoV-2 antigen. It is important not to forget the probability of atypical presentations of latent viruses to make a timely diagnosis and treatment of patients.

Preparation and application of high titer neutralizing antibody against varicella-herpes zoster virus / 中国生物制品学杂志

@#Objective To prepare high titer specific immune serum of varicella-herpes zoster virus(VZV)for the quality control of live attenuated varicella vaccine and live attenuated herpes zoster vaccine.MethodsMale rabbits were immunized with high purity recombinant gE glycoprotein combined with Freund's adjuvant,aluminum hydroxide adjuvant or MF59 adjuvant,2 rabbits in each group. On the 56th day after immunization,the maximum blood samples(heart or carotid artery)were collected from each rabbit to prepare serum,which was mixed with VZV for neutralization reaction,and then inoculated into a 6-well plate full of monolayer of MRC-5 human diploid cells. After incubation for 7 d,the number of plaques was counted and the neutralizing titer and virus neutralizing ability of immune serumwere determined. The serum with high neutralizing titer and virus neutralizing ability was selected for the identification test of live attenuated varicella vaccine and live attenuated herpes zoster vaccine VZV(Oka strain)working seed lot and the detection of exogenous virus factors.ResultsThe immune sera prepared by immunizing rabbits with various combinations of recombinant gE glycoprotein all showed neutralizing activity,among which the serum prepared by the combination of recombinant gE glycoprotein and Freund's adjuvant had the highest neutralizing titer of 1∶512 and the virus neutralizing ability of 240 000 PFU/mL;The prepared immune serum was usedfor the identification test of VZV(Oka strain)working seed lot and the detection of exogenous virus factors,of which all the results were in line with the requirements. Conclusion The recombinantgE glycoprotein could be used for the preparation of high titer neutralizing antibody against VZV,and the prepared high titer neutralizing antibody is suitable for thequality control of live attenuated varicella vaccine and live attenuated herpes zoster vaccine.

Changes in CD100 expression and its regulatory effect on CD8 + T cell function in peripheral blood of patients with herpes zoster / 中华皮肤科杂志

Objective:To investigate changes in expression of plasma soluble CD100 (sCD100) and membrane-bound CD100 (mCD100) on peripheral T cells in patients with herpes zoster, and to observe the regulatory effect of exogenous CD100 on CD8 + T cells. Methods:A total of 53 patients with herpes zoster attending the Zhumadian Central Hospital from July 2019 to April 2021 were enrolled, so were 25 age- and sex-matched healthy controls. Anticoagulated venous blood samples were collected, plasma and peripheral blood mononuclear cells were isolated, plasma sCD100 levels were detected by enzyme-linked immunosorbent assay, and mCD100 expression on CD4 + and CD8 + T cells was determined by flow cytometry. After the purification of CD8 + T cells, the secretion levels of cytotoxic molecules and cytokines by CD8 + T cells were measured and compared between herpes zoster patients and controls. Some purified CD8 + T cells from herpes zoster patients were stimulated with recombinant human CD100 and recombinant varicella-zoster virus glycoprotein, and the effect of recombinant human CD100 on the secretion of cytotoxic molecules and cytokines by CD8 + T cells was investigated. Comparisons between groups were conducted by t test. Results:Plasma sCD100 levels were significantly lower in the herpes zoster group (1.12 ± 0.23 ng/ml) than in the control group (1.31 ± 0.28 ng/ml, t = 2.97, P = 0.004), the proportion of mCD100 + CD8 + T cells was significantly higher in the herpes zoster group (17.41% ± 4.26%) than in the control group (14.69% ± 3.70%, t = 2.52, P = 0.014), and no significant difference in the proportion of mCD100 + CD4 + T cells was found between the two groups (2.52% ± 0.58% vs. 2.32% ± 0.56%, t = 1.27, P = 0.208). The herpes zoster group showed significantly decreased mRNA expression of perforin and granzyme B in, and lower secretion levels of perforin, granzyme B, interferon-γ and tumor necrosis factor-α by CD8 + T cells compared with the control group (all P < 0.05). After stimulation with recombinant human CD100, levels of perforin, granzyme B, interferon-γ and tumor necrosis factor-α in the culture supernatant of CD8 + T cells (43.68 ± 14.12, 126.8 ± 22.92, 12.79 ± 3.66, 310.0 ± 79.90 pg/ml, respectively ) were significantly higher than those in non-stimulated group (34.55 ± 10.78, 99.04 ± 10.44, 9.53 ± 2.00, 275.6 ± 68.04 pg/ml, respectively, all P < 0.05) . Conclusion:There was an imbalance between sCD100 and mCD100 expression in patients with herpes zoster, and exogenous sCD100 may enhance the cytotoxicity of CD8 + T cells in herpes zoster patients.

Reasonable selection of antiviral agents for herpes zoster / 中华皮肤科杂志

Antiviral treatment is the core part in the treatment of herpes zoster. Based on the latest studies, consensus and guidelines, this article aims to provide a basis and reference for clinicians to make a reasonable choice of types and doses of antiviral agents. Valacyclovir, a precursor of acyclovir with high oral bioavailability and great convenience of administration, is generally the first choice of oral antiviral agents; for some special cases, such as immunocompromised patients, intravenous drips of acyclovir should be selected when appropriate. Brivudine is often a better choice for patients with severe renal insufficiency; famciclovir or other antiviral agents should be considered for patients resistant to acyclovir; for immunocompromised patients resistant to acyclovir, intravenous drips of foscarnet sodium can be an option. Oral antiviral agents should be administered at adequate doses. Selecting appropriate antiviral agents and their doses can effectively relieve acute symptoms of patients and reduce the probability of postherpetic neuralgia.

Systematic evaluation of acute herpes zoster treatment with fire needle therapy mainly / 国际中医中药杂志

Objective:To systematically evaluate the clinical efficacy of fire needle therapy and conventional western medicine in the treatment of patients with acute herpes zoster.Methods:Randomized controlled trials (RCTs) of fire needle therapy in the treatment of acute herpes zoster were retrieved from China National Knowledge Internet (CNKI), Wanfang, Database of Chinese Sci Tech Periodicals (VIP Database), China Biomedical Literature Database (CBM), Medline, Embase, and Cochrane Library from the establishment of the databases to May 30, 2022. According to the inclusion and exclusion criteria, the included literature was screened, and Review Manager 5.3 was used for system evaluation and meta-analysis.Results:7 articles were included for analysis after screening, involving 452 patients. There were 226 cases in the treatment group and 226 cases in the control group. The results of meta-analysis showed that fire needle therapy was superior to conventional western medicine in the total effective rate [ RR=0.36, 95% CI (0.20, 0.65), P=0.000 7], lower incidence of PHN [ RR=0.25, 95% CI (0.09, 0.72), P=0.01], lower VAS score [ MD=-1.19, 95% CI (-2.14, -0.24), P=0.01], and shorter scab forming time [ MD=-2.03, 95% CI (-2.42, -1.64), P<0.001]. Conclusion:The curative effect of fire needle therapy is more prominent than that of conventional western medicine in the treatment of acute herpes zoster.

Incidence of cutaneous carcinoma, herpes zoster and cataracts in patients with psoriasis vulgaris receiving narrow-band ultraviolet B phototherapy: a single-center retrospective study / 中华皮肤科杂志

Objective:To investigate the effect of narrow-band ultraviolet B (NB-UVB) phototherapy on the incidence of cutaneous carcinoma, herpes zoster and cataracts in patients with psoriasis vulgaris.Methods:A telephone follow-up was conducted among patients with psoriasis vulgaris receiving NB-UVB phototherapy at the Department of Dermatology, Peking Union Medical College Hospital from January 1, 2003 to December 31, 2019. The incidence of cutaneous carcinoma, herpes zoster and cataracts was investigated, and their incidence density and 95% confidence intervals ( CIs) were calculated. Subgroup analyses were performed according to the cumulative number of NB-UVB radiation (≤ 100 times, 101 - 300 times, > 300 times), cumulative radiation energy (≤ 100 J/cm 2, > 100 - 500 J/cm 2, > 500 J/cm 2), and average radiation frequency (≤ 1.5 times/week, > 1.5 times/week). Univariate Cox′s proportional hazards regression analysis was conducted to analyze differences in the incidence density of cutaneous carcinoma, herpes zoster, and cataracts between the groups, and the results were expressed as hazard ratios ( HRs) and their corresponding 95% CIs. Results:A total of 160 patients with psoriasis vulgaris completed the follow-up, including 99 males (61.9%) and 61 females (38.1%). Their ages (median [ Q1, Q3]) were 39 (28.3, 54.8) years, the cumulative numbers of NB-UVB radiation were 129.5 (52, 291) times, the cumulative radiation energy was 226.3 (71.1, 688.9) J/cm 2, and the average radiation frequencies were 1.57 (1.37, 1.83) times/week. No cutaneous carcinoma occurred during the follow-up of 1 288.87 person-years (7.77 [5.11, 9.92] years) ; herpes zoster occurred in 4 cases during the follow-up of 1 273.85 person-years (7.68 [5.11, 9.88] years), and the estimated incidence density of herpes zoster was 31.4/10 000 person-years (95% CI: [11.8 - 83.5]/10 000 person-years) ; cataracts occurred in 8 cases during the follow-up of 1 264.67 person-years (7.72 [4.84, 9.83] years), and the estimated incidence density of cataracts was 63.3/10 000 person-years (95% CI: [31.7 - 126.2]/10 000 person-years). No significant differences were observed in the incidence density of herpes zoster or cataracts among subgroups with different cumulative numbers of NB-UVB radiation, cumulative radiation energy and average radiation frequencies (all P > 0.05) . Conclusion:The incidence of herpes zoster or cataracts may not be affected by the cumulative number of NB-UVB radiation, cumulative radiation energy or average radiation frequency in patients with psoriasis vulgaris.

Secondary herpes zoster wound cured by allogeneic platelet-rich plasma: a case report / 中国输血杂志

【Objective】 To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of herpes zoster wounds secondary to systemic lupus erythematosus (SLE), especially large ulcer wounds. 【Methods】 The treatment process of a patient with massive herpes zoster wounds in perineum and hip accompanied by extensive soft tissue necrosis secondary to SLE was retrospectively analyzed. The clinical efficacy of allogeneic PRP was explored combined with treatment key points and literature review. 【Results】 The patient′s wound bed was prepared until the wound was fresh, then treated externally with allogeneic PRP 3 times a week. The wound was healed completely after 42 days. 【Conclusion】 In the case of autologous PRP unavailable or unsuitable, allogeneic PRP is a safe alternative, which can effectively promote tissue regeneration, and this patient achieved curative effect in a short period of time.

Clinical efficacy of fire needling combined with cupping therapy on herpes zoster of acute stage and the effect on Th17/Treg cellular immune balance / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between the combined therapy of fire needling and cupping, and western medication on herpes zoster of acute stage, as well as the effects on Th17 and Treg cells and inflammatory factors, i.e. IL-10 and IL-17 in the peripheral blood.@*METHODS@#Eighty patients with herpes zoster of acute stage were randomly divided into a combined therapy (fire needling plus cupping) group and a western medication group, 40 cases in each one. In the combined therapy group, the pricking and scattering techniques with fire needle were used at ashi points and Jiaji (EX-B 2) corresponding to the affected spinal segments; afterwards, cupping therapy was delivered. The combined treatment was given once daily. In the western medication group, valaciclovir hydrochloride tablet and vitamin B1 tablet were administered orally. The duration of treatment in each group was 10 days. Before each treatment from day 1 to day 10 and on day 11 , the score of symptoms and physical signs was observed in the two groups separately. Before each treatment from day 1 to day 10 and on day 11, 30, 60, the score of visual analogue scale (VAS) and skin lesion indexes were observed in the two groups. On day 60, the incidence of postherpetic neuralgia was recorded in the two groups. The levels of Th17 and Treg cells, Th17/Treg ratio in the peripheral blood, as well as serum levels of IL-10 and IL-17 were detected before and after treatment in the two groups. The clinical efficacy was compared between the two groups.@*RESULTS@#From day 6 to day 10 during treatment and on day 11, the scores of symptoms and physical signs in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 3, day 6 to day 10 during treatment and day 11, day 30, VAS scores in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 60, the incidence of postherpetic neuralgia in the combined therapy group was lower compared with that in the western medication group (P<0.05). The blister arresting time and scabbing time in the combined therapy group were shorter than those of the western medication group (P<0.05). After treatment, the level of Th17, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 were all lower in comparison with those in the western medication group (P<0.05). The curative and remarkably effective rate was 82.5% (33/40) in the combined therapy group, higher than 62.5% (25/40) in the western medication group (P<0.05).@*CONCLUSION@#The early application of fire needling combined with cupping therapy can effectively treat herpes zoster of acute stage, relieve pain, and reduce the incidence of postherpetic neuralgia, which may be related to reducing the levels of Th17 and Treg cells, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 so that the cellular immune balance is modulated.

Clinical analysis of 58 cases of type 2 diabetes mellitus complicated by herpes zoster / 中国基层医药

Objective:To analyze and summarize the clinical characteristics of type 2 diabetes mellitus complicated by herpes zoster in patients and investigate the correlation between the two.Methods:The clinical data of 58 patients with type 2 diabetes mellitus complicated by herpes zoster who received treatment in Department of Dermatology, The Second People's Hospital of Hefei (Hefei Hospital Affiliated to Anhui Medical University) from January 2020 to January 2023 were retrospectively analyzed.Results:All 58 patients with type 2 diabetes mellitus complicated by herpes zoster were over the age of 70 years. The average length of hospital stay was (11.78 ± 3.63) days. Among these patients, three developed disseminated herpes zoster, while twenty-three developed postherpetic neuralgia. The average glycated hemoglobin level of the patients was (7.92 ± 1.51)%, all of which were higher than the normal range.Conclusion:The poor control of blood sugar in patients with type 2 diabetes mellitus may increase the risk of herpes zoster. The duration of hospital stay after herpes zoster development is long, and the incidence of postherpetic neuralgia is high.

Manifestação atípica do herpes zóster em boca: relato de caso / Atypical manifestation of herpes zoster in the mouth: case report / Manifestación atípica de herpes zoster en boca: reporte de caso

O herpes-zóster é uma infecção viral causada pela reativação do vírus da varicela-zóster (VZV) sendo os ramos do nervo trigêmeo afetados em até 20% dos casos. Apresenta-se comumente com dor em queimação e caracteristicamente, o zoster se manifesta como uma erupção vesicular unilateral que aparece na face, cabeça, tronco e até mesmo nas extremidades, variando de lesão leve e de rápida cicatrização à lesões graves e extensas com duração de semanas. Embora se reconheça que o zoster pode ocorrer sem exantema, classicamente apresenta-se como dermátomo unilateral, doloroso e/ou pruriginoso. A terapia fotodinâmica antimicrobiana (aPDT) tem sido indicada como uma modalidade promissora no tratamento de potenciais lesões infecciosas. Neste trabalho será relatado o caso clínico de um paciente diagnosticado com herpes zóster com manifestação atípica e que recebeu tratamento medicamentoso convencional associado à aPDT.

Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus (VZV), with the branches of the trigeminal nerve affected in up to 20% of cases. It commonly presents with burning pain and characteristically, zoster manifests as a unilateral vesicular eruption appearing on the face, head, trunk, and even the extremities, ranging from a mild, rapidly healing lesion to severe, extensive lesions lasting up to weeks. Although it is recognized that zoster can occur without rash, it classically presents as a unilateral, painful and/or pruritic dermatome. Antimicrobial photodynamic therapy (aPDT) has been indicated as a promising modality in the treatment of potential infectious lesions. In this work, the clinical case of a patient diagnosed with herpes zoster with atypical manifestation and who received conventional drug treatment associated with aPDT will be reported.

El herpes zóster es una infección vírica provocada por la reactivación del virus de la varicela zóster (VZV), con afectación de las ramas del nervio trigémino hasta en un 20% de los casos. Comúnmente se presenta con dolor ardiente y característicamente, el zoster se manifiesta como una erupción vesicular unilateral que aparece en la cara, la cabeza, el tronco e incluso las extremidades, que van desde una lesión leve que cura rápidamente hasta lesiones graves y extensas que duran semanas. Aunque se reconoce que el herpes zoster puede ocurrir sin exantema, clásicamente se presenta como un dermatoma unilateral, doloroso y/o pruriginoso. La terapia fotodinámica antimicrobiana (aPDT) se ha indicado como una modalidad prometedora en el tratamiento de posibles lesiones infecciosas. En este trabajo se reportará el caso clínico de un paciente diagnosticado de herpes zoster con manifestación atípica y que recibió tratamiento farmacológico convencional asociado a TFPa.

Vacunación contra el herpes zóster en Argentina / Vaccination against herpes zoster in Argentina

Durante los últimos meses, quienes trabajamos en Argentina en el ámbito de la atención primaria como médicos de cabecera hemos recibido muchas consultas de pacientes solicitando nuestra opinión sobre una vacuna que no está actualmente incluida en el Calendario Nacional de Vacunación y que además estaba fuera de nuestra agenda: la vacuna contra el herpes zóster. Este artículo editorial pretende ayudar a los equipos de salud a realizar con sus pacientes un proceso de toma de decisiones compartidas en las consultas acerca de esta nueva vacuna. (AU)

During the last few months, those of us who work in Argentina in the field of primary care as general practitioners have received many inquiries from patients requesting our opinion about a vaccine that is not currently included in the National Vaccination Schedule and that, in addition, was off our scope: the herpes zoster vaccine. This editorial article aims to help our health teams carry out a shared decision-making process with their patients regarding this new vaccine. (AU)