Herpes Zoster in Children: A Clinico- Epidemiological Study Over 4 Years at A Tertiary Center in Gujarat
Keywords:
Childhood, herpes zoster, immunosuppressionAbstract
Introduction: Earlier considered a rare disease, childhood herpes zoster is showing an increasing incidence. This study was con- ducted to study the clinical features of herpes zoster (HZ) in chil- dren below 12 years of age along with immune suppression status.
Materials and Methods: The study was carried out in the Depart- ment of Dermatology at a Tertiary Care Centre in Gujarat for 4 years. Children aged ≤12 years with a diagnosis of HZ were en- rolled in a predesigned pro forma. Diagnosis was mainly clinical with use of Tzanck smears in difficult cases. ELISA for HIV was done in all cases.
Results: Total of 51 children aged ≤12 years were enrolled in the study. Male predominance was seen. The mean age was 8.74 years. 72.5% patients had localized dermatomal involvement and dis- semination was not seen. Majority of patients (51%) did not have any preceding symptoms. Prior exposure to varicella was present in only 19 (37.3%) cases. Evidence of immunosuppression on his- tory, clinical examination, and investigations was present in 11(21.5%).
Conclusion: Although childhood HZ is increasing, atypical pres- entations and dissemination are rare. Immunosuppression does not play a major role in these patients. We conclude that HZ in children follows a relatively benign course as compared to adults.
References
Gnann JW, Whitley RJ. Herpes zoster. N Engl J Med 2002; 347:340–6.
Wurzel CL, Kahan J, Heitler M et al. Prognosis of herpes zoster in healthy children. Am J Dis Child 1986; 140:477– 8.
Prabhu S, Sripathi H, Gupta S et al. Childhood herpes zos- ter: A clustering of ten cases. Indian J Dermatol. 2009;54:62- 4.
Takayama N, Yamada H, Kaku H et al. Herpes zoster in immunocompetent and immunocompromised Japanese children. Pediatr Int. 2000;42:275-9.
Terada K. Characteristics of herpes zoster in otherwise normal children. Pediatr Infect Dis J. 1993;12:960-961
Yaeen A, Ahmad QM, Farhana A et al. Indian Dermatol Online J. 2015 Nov-Dec;6(6):381-6
Berger R, Florent G, Just M. Decrease in the lymphoprolif- erative response to varicellazoster virus antigen in the aged. Infect Immun.1981;32:24-7.
Kurlan JG, Connelly BL, Lucky AW. Herpes zoster in the first year of life following postnatal exposure to varicella zoster virus: Four case reports and a review of infantile herpes zoster. Arch Dermatol.2004;140:1268-72.
Ragozzino MW, Melton L J III, Kurland LT et al. Popula- tion-based study of herpes zoster and its sequelae. Medi- cine (Baltimore).1982;61:310-6.
Herpes zoster. Available at: http://www.emedicine.com
/ped/topic996.htm. Accessed on July 11th,2016.
Terada K, Tanaka H, Kawano S et al. Specific cellular im- munity in immunocompetent children with herpes zoster. Acta Paediatr. 1998;87:692-4.
Bhushan P, Sardana K, Mahajan S. Dermatomal vesicular eruption in an asymptomatic infant. Dermatol Online J. 2005;11:26
Solomon AR. New diagnostic tests for herpes simplex and varicella zoster infection. J Am Acad Dermatol. 1988; 18: 218-21..
Guess HA, Broughton DD, Melton L J III et al. Epidemiol- ogy of herpes zoster in children and adolescents: a popula- tionbased study. Pediatrics. 1985;76:512-7.
Lamees Mahmood Malik, Nadia Ali Azfar, Abdur Rahim Khan et al.Herpes zoster in children. Journal of Pakistan Association of Dermatologists 2013;23 (3):2267-271.
Latif R, Shope TC. Herpes zoster in normal and immuno- compromised children. Am J Dis Child. 1983;137:801-2.
Terada K, Kawano S, Yoshihiro K et al. Varicella-zoster virus (VZV) reactivation is related to the low response of VZVspecific immunity after chickenpox in infancy. J Infect Dis. 1994;169:650-2.
Lewkonia IK, Jackson AA. Infantile herpes zoster after in- trauterine exposure to varicella. BMJ. 1973;3:149.
Enders G, Miller E, Cradock-Watson J et al. Consequences of varicella and herpes zoster in pregnancy: prospective study of 1739 cases. Lancet. 1994;343:1548-51
Smith CG, Glaser DA. Herpes zoster in childhood: case report and review of the literature. Pediatr Dermatol. 1996;13:226-9.
Baba K, Yabuuchi H, Takahashi M, Ogra PL. Increased incidence of herpes zoster in normal children infected with varicella zoster virus during infancy: communitybased fol- low-up study. J Pediatr. 1986;108:372-7.
von Seidlin L, Gillette SG, Bryson MD et al. Frequent re- currence and persistence of varicella zoster virus infection in children infected with human immunodeficiency virus type 1. J Pediatr. 1996;128:52-7.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.