TY - JOUR
T1 - Natural history of herpes zoster
T2 - Late follow-up of 3.9 years (n = 43) and 7.7 years (n = 10)
AU - Reda, Haatem
AU - Greene, Kaitlin
AU - Rice, Frank L.
AU - Rowbotham, Michael C.
AU - Petersen, Karin L.
N1 - Funding Information:
Supported by the CPMCRI Neuropathic Pain Research Gift Fund , the CPMCRI Medical Student Research Fellowship Gift Fund , and NINDS Grants R0-1 NS39521 (Drs Petersen and Rowbotham) and K24 NS02164 (Dr Rowbotham).
PY - 2013/10
Y1 - 2013/10
N2 - Postherpetic neuralgia (PHN) is a common complication after herpes zoster (HZ). Subjects who completed a longitudinal observational 6-month study (4 visits) of the natural history of HZ were recontacted for 2 additional follow-up visits that included pain and sensory symptom assessment, quantitative sensory testing, capsaicin response test, and 3-mm punch skin biopsies in HZ-affected, mirror-image, and control skin sites. Forty-three subjects (14 with PHN at 6 months) of the original 94 subjects in the cohort were comprehensively assessed at a median 3.9 years after HZ onset (visit 5), and 10 subjects underwent a final assessment at a median 7.7 years after HZ onset (visit 6). At 3.9 years, none of the 29 subjects who had been pain free at 6 months had a recurrence of pain. Only 2 of the 14 subjects with PHN at 6 months still had pain at 3.9 years. One subject with PHN at 6 months was free of symptoms at 3.9 years but had very mild pain at 7.7 years. Sensory function continued on a path toward normalization, but was still abnormal in many subjects, especially those who met criteria for PHN at 6 months. Even at 7.7 years, reinnervation of HZ-affected skin was not apparent.
AB - Postherpetic neuralgia (PHN) is a common complication after herpes zoster (HZ). Subjects who completed a longitudinal observational 6-month study (4 visits) of the natural history of HZ were recontacted for 2 additional follow-up visits that included pain and sensory symptom assessment, quantitative sensory testing, capsaicin response test, and 3-mm punch skin biopsies in HZ-affected, mirror-image, and control skin sites. Forty-three subjects (14 with PHN at 6 months) of the original 94 subjects in the cohort were comprehensively assessed at a median 3.9 years after HZ onset (visit 5), and 10 subjects underwent a final assessment at a median 7.7 years after HZ onset (visit 6). At 3.9 years, none of the 29 subjects who had been pain free at 6 months had a recurrence of pain. Only 2 of the 14 subjects with PHN at 6 months still had pain at 3.9 years. One subject with PHN at 6 months was free of symptoms at 3.9 years but had very mild pain at 7.7 years. Sensory function continued on a path toward normalization, but was still abnormal in many subjects, especially those who met criteria for PHN at 6 months. Even at 7.7 years, reinnervation of HZ-affected skin was not apparent.
KW - Capsaicin response test Chronic pain Postherpetic neuralgia Quantitative sensory testing Thermal
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U2 - 10.1016/j.pain.2013.04.015
DO - 10.1016/j.pain.2013.04.015
M3 - Article
C2 - 23719573
AN - SCOPUS:84884288215
SN - 0304-3959
VL - 154
SP - 2227
EP - 2233
JO - Pain
JF - Pain
IS - 10
ER -