A Clinical Study of 72 Cases of Herpes Zoster in Children and Adolescents

Park, Soo Jung; Song, Hyun Jeung; Kim, Chang Wook; Lee, Kyu Suk

Abstract

BACKGROUND
Herpes zoster is a common dermatologic disorder, and the incidence in both adults and children has recently increased.
OBJECTIVE
The aim of this study is to confirm epidemiological features and clinical characteristics of herpes zoster among children and adolescents.
METHODS
Medical records were reviewed for 72 patients under 18 years old with herpes zoster during an 11-year-period from January 1994 to December 2004. These patients were evaluated with regard to gender, age, dermatomal distribution, the interval between varicella and herpes zoster, underlying disease and complication.
RESULTS
Children and adolescents (under 18 years old) constituted 5.7% (72 cases of 1,271) of total herpes zoster patients. The ratio of male to female patients was 1 : 1, and the mean age was 10.0 years. The age distribution was 18% in 0~4 years (13 patients), 27.7% in 5~9 years (20 patients), 33.3% in 10~14 years (24 patients), and 20.8% in 15~18 years (15 patients). Underlying diseases were observed in 52.8% of the patients (38/72 patients). The most common dermatomal distribution was thorasic dermatome (48.6%), followed by trigerminal (23.6%), cervical (15.2%), lumbar (8.3%) and sacral (4.1%) involvement. The complication of herpes zoster was observed in 27.7% of the patients (20/72 patients), and the two most common complications were menigitis (8.3%) and conjunctivitis (8.3%), followed by secondary wound infection (4.1%), generalization of zoster infection (2.7%), Ramsay-Hunt syndrome (2.7%) and postherpetic neuralgia (1.3%). Information on the age onset of varcella was available only in 58.3% of the patients (42/72 patients). The mean age onset of varicella was 2.5 years old, with the peak period between 0~1 years old (17/42 patients).
CONCLUSION
In children and adolescents with herpes zoster, the gender ratio and dermatomal distribution were similar to those previously reported, except for the increased rate of underlying diseases. The incidence of postherpetic neuralgia was also lower than that of adults. Onset of varicella before 1 year of age might be a risk factor for herpes zoster in children and adolescents.