The clinical course of herpes zoster: A prospective study in primary care

Objectives: To determine the incidence of herpes zoster (HZ) and frequency of complications, mainly the incidence of postherpetic neuralgia (PHN).Design: Prospective follow-up study.Setting: Primary health care in Iceland.Main outcome measures: Incidence of HZ, age and sex distribution of patients and discomfort or pain 1, 3 and 12 months after the rash.Results: During an observation period of 229,547 person years, 462 episodes of acute zoster developed (incidence equals; 2.0/1,000/year) in 457 patients. End points were gained for all (100%) after 12 months follow up. Those still having pain after 12 months were followed further, 23 to 57 months more. Systemic acyclovir was used in less than 4%. A fourth of all HZ cases occurred in children and teenagers. PHN was rare in patients younger than 60 years of age; 2% and 1% experienced only mild pain at 3 and 12 months respectively. No patient had moderate or severe pain in this age group at these time points. In contrast pain was experienced by 19% and 8% of ...

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