Clinical and psychosocial correlates of acute pain in herpes zoster.
BACKGROUND
Acute and persistent pain are the most significant clinical manifestations of herpes zoster (HZ), but the characteristics of acute pain in HZ patients have been inadequately investigated.


OBJECTIVE
To correlate the severity of acute pain with clinical, demographic and psychosocial characteristics of HZ patients.


METHODS
Five hundred thirty-three patients with acute HZ were recruited by 119 dermatologists who collected medical and demographic data at diagnosis, provided counselling and therapy where appropriate and asked the patients to complete the Short Italian Questionnaire designed for comprehensive evaluation of HZ patients.


RESULTS
In a univariate analysis, greater acute pain severity was significantly associated with female gender, number of dermatomes affected, presence of prodromal pain, abnormal sensations (dysesthesia), education level, anxiety and depression. Quality of life, even if greatly reduced, did not correlate with the intensity of pain. In a multivariate model, the intensity of pain was independently associated with the extent of rash (p=0.042), presence of prodromal pain (p=0.005), dysesthesia, education level (p=0.040), and depression (p<0.001), but not with gender, anxiety or quality of life.


CONCLUSIONS
This study suggests that in patients with acute HZ the severity of the disease and depression at presentation are the main correlates of pain intensity.
Volpi
Antonio
A
Department of Public Health, University of Rome Tor Vergata, Italy. volpi@med.uniroma2.it <volpi@med.uniroma2.it>
Gatti
Antonio
A
Serafini
Giuseppe
G
Costa
Bruno
B
Suligoi
Barbara
B
Pica
Francesca
F
Marsella
Luigi T
LT
Sabato
Elisabetta
E
Sabato
Alessandro F
AF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways; D003710:Demography; D004493:Education; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000453:epidemiology* / Q000523:psychology*; D011584:Psychology; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires