J Korean Pain Soc.  1999 Nov;12(2):246-249.

A Case of Postherpetic Neuralgia Treated with Skin Excision

• Lee KJ
• Han SG
• Kim JS
• Yoon SH
• Lee YS

Abstract

Postherpetic neuralgia (PHN) is defined as the persistence of pain after recovery from herpes zoster (HZ), when the rash has healed, usually after about 4 weeks. PHN is the most feared complication of herpes zoster and remains one of the most common and intractable chronic pain disorders, Recent evidence has shed some light on the possible mechanism of pain, and on the prophylactic and treatment approaches to PHN, but there is no secure therapy. This report is a case of a 70-year-old male with PHN, affecting the 8th to 10th thoracic dermatomes. Patient complains of allodynia and hyperalgesia on the affected skins. After sympathectomy, antidepressant, anticonvulsant, and capsaicin ointment application, much pain relief was achieved, but allodynia remained at the subcostal area about 7 X 3 cm2 in size. We decided to remove the painful area. Skin excision was done under local anesthesia. After skin excision, the pain was decreased and patient did not complain of pain for 10 months.

Keyword

Pain, postherpetic neuralgia (PHN); Treatment, skin excision

MeSH Terms

Aged
Anesthesia, Local
Capsaicin
Chronic Pain
Exanthema
Herpes Zoster
Humans
Hyperalgesia
Male
Neuralgia, Postherpetic*
Skin*
Sympathectomy
Capsaicin