Clinico-Epidemiological Profile of Immunocompetent Patients Diagnosed with Herpes Zoster: A Single-Center Retrospective Cohort Study from Sinop

Abstract

Aim: Herpes zoster (HZ) mainly occurs in immunocompetent individuals, even though immunosuppression is a well-known risk factor. The aim of this study was to evaluate the demographic and clinical features of immunocompetent HZ patients and HZ-related complications with a special focus on possible contributing factors. Material and Methods: This single-center, retrospective cohort study included 98 patients with no known immunosuppressive condition out of 103 patients diagnosed with HZ between September 2019 and August 2020. The patients were evaluated in terms of age, sex, medical history, clinical features, triggering factors, seasonality, complications, and neutrophil-to-lymphocyte ratio (NLR) as a marker of systemic inflammation. Results: Ninetyeight immunocompetent patients (male:female ratio=1.1:1) were diagnosed with HZ, with a median age of 59 years (age range: 5-88). Thoracic dermatome was the leading dermatome (n=45). Trigeminal nerve was involved in 11 patients, eight of them presenting with ophthalmic HZ. HZ attacks were mainly detected in summer, while ophthalmic HZ cases were exclusively diagnosed during fall and winter. Two patients developed ophthalmic HZ following trauma. Eleven patients experienced postherpetic neuralgia (PHN) during follow-up with a male predominance (p=0.009). A higher mean NLR value was detected in PHN patients, although it was not statistically significant (p=0.136). Conclusion: The findings of our study are compatible with the current literature regarding the main presentation pattern of HZ as unilateral thoracic dermatome involvement and the complications such as PHN and ophthalmic HZ occurring in a subgroup of patients. The high HZ incidence rate in our series is likely due to the high median age of the population in our region. The summer peak of HZ cases further supports the seasonal variability due to the ultraviolet effect, whereas mechanical trauma is another possible triggering factor. The predictive value of NLR for PHN should be evaluated in further studies.