Clinical Features of Herpes Zoster in Children according to Immune Status.

Choi,  Young Bin; Kim,  Dong Hyun; Kwon,  Young Se

doi:2018.26.3.170

Ann Child Neurol > Volume 26(3); 2018 > Article

Original Article

Journal of the Korean Child Neurology Society 2018;26(3):170-174.
DOI: https://doi.org/10.26815/jkcns.2018.26.3.170 Published online September 30, 2018.

Clinical Features of Herpes Zoster in Children according to Immune Status.

Young Bin Choi, Dong Hyun Kim, Young Se Kwon

Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea. ysped@inha.ac.kr

Abstract

PURPOSE
Herpes zoster appears in all ages and its incidence progressively increase. It is more common in elderly people or immunocompromised people and can be accompanied by serious complications. This study was performed to investigate the clinical manifestation of herpes zoster according to immune status in children. METHODS: This study was retrospectively included 307 children under 18 years who were diagnosed and treated with herpes zoster at Inha University Hospital from 1997 to 2017 based on medical records. These patients were divided into two groups according to their immunity and their clinical features were compared. RESULTS: The mean age of the total 307 patients was 10.2 years, 151 (49.2%) in males. Eighty-seven patients were hospitalized and 220 patients were treated in an outpatient clinic. Most patients received antiviral treatment. The most common dermatomal distribution of the skin lesion was the thoracic region, followed by trigeminal, lumbar and sacral, cervical region. Twenty-one patients were immunocompromised and fifteen of them were hematologic disorders. Admission rate, history of chickenpox and mean duration of treatment were significantly higher in immunocompromised group (P < 0.05). There was no significant difference in age, dermatomal distribution and complication between the two groups. Complications were observed in 50 cases and more than half of them were zoster ophthalmicus. Another complication was Ramsay-Hunt syndrome, meningitis and skin infection. CONCLUSION: Immunocompromised patients had a longer duration of treatment and a higher history of chickenpox. The incidence of complications, dermatomal distribution and age did not differ from that of immunocompetent children.

Key Words: Herpes zoster, Child, Adolescent, Immune System