Clinical Features and Risk Factors for Complications of Facial Herpes Zoster in Inpatients

Background: Few studies have been reported on facial herpes zoster and the risk factors for its complications. Objective: This study aimed to investigate the clinical features and risk factors with facial herpes zoster. Methods: We examined the medical records of 676 patients with facial herpes zoster during a 10-year-period from 2011 to 2020. We assessed the proportion of ocular complications, Ramsay-Hunt syndrome, and postherpetic neuralgia in patients with facial herpes zoster according to several clinical factors including age, sex, dermatomes, underlying disease, and time to initiate antiviral treatment. Results: The incidence of ocular complications was significantly higher in males (Odds ratia [OR], 2.59; 95% CI, 1.26~5.32), and with involvement of ophthalmic branches of the trigeminal nerve (V1: OR, 14.28; 95% CI, 3.62~56.29; V1 inclusion: OR, 20.68; 95% CI, 7.99~53.55), underlying diseases (OR, 1.70; 95% CI, 1.08~2.68) and positive Hutchinson's sign (OR, 3.59; 95% CI, 1.72~7.49). Ramsay-Hunt syndrome was significantly correlated with involvement of VII dermatome (OR, 24.68; 95% CI, 2.97~204.75), and showed considerable significant with otalgia (OR, 3.31; 95% CI 0.98~11.22). Postherpetic neuralgia was significantly higher in those over 60 years of age (OR, 2.03; 95% CI, 1.48~2.78), ocular complications (OR, 2.28; 95% CI, 1.57~3.30), and ear involvement (OR 1.94; 95% CI 1.17~3.20). Conclusion: These results demonstrated that facial herpes zoster was associated with ocular complications, Ramsay-Hunt syndrome, and postherpetic neuralgia. The incidence of these complications was related to risk factors such as sex, age, dermatome, underlying disease, Hutchinson's sign and otalgia. To decrease the risk of complications associated with facial herpes zoster, patients should receive appropriate antiviral therapy and interdepartmental consultations immediately.