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Review Article

Korean J Pain 2015; 28(3): 177-184

Published online July 31, 2015 https://doi.org/10.3344/kjp.2015.28.3.177

Copyright © The Korean Pain Society.

Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment

Young Hoon Jeon*

Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea.

Correspondence to: Young Hoon Jeon. Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, 188-1 Samduck-dong 2 ga, Jung-gu, Daegu 700-412, Korea. Tel: +82-53-420-5871, Fax: +82-53-426-2760, jeon68@knu.ac.kr

Received: May 16, 2015; Revised: May 23, 2015; Accepted: May 26, 2015

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.

Keywords: Analgesic, Herpes zoster, Intervention, Postherpetic neuralgia, Vaccination, Varicella zoster virus