title: Natural history of herpes zoster: late follow-up of 3.9 years (n=43) and 7.7 years (n=10).
abstract: Postherpetic neuralgia (PHN) is a common complication after herpes zoster (HZ). Subjects who completed a longitudinal observational 6-month study (4 visits) of the natural history of HZ were recontacted for 2 additional follow-up visits that included pain and sensory symptom assessment, quantitative sensory testing, capsaicin response test, and 3-mm punch skin biopsies in HZ-affected, mirror-image, and control skin sites. Forty-three subjects (14 with PHN at 6 months) of the original 94 subjects in the cohort were comprehensively assessed at a median 3.9 years after HZ onset (visit 5), and 10 subjects underwent a final assessment at a median 7.7 years after HZ onset (visit 6). At 3.9 years, none of the 29 subjects who had been pain free at 6 months had a recurrence of pain. Only 2 of the 14 subjects with PHN at 6 months still had pain at 3.9 years. One subject with PHN at 6 months was free of symptoms at 3.9 years but had very mild pain at 7.7 years. Sensory function continued on a path toward normalization, but was still abnormal in many subjects, especially those who met criteria for PHN at 6 months. Even at 7.7 years, reinnervation of HZ-affected skin was not apparent.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA California Pacific Medical Center Research Institute, San Francisco, CA 94107, USA Albany Medical College, Albany, NY 12208, USA.
authors.forename: Haatem
authors.initials: H
authors.lastname: Reda
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Greene
authors.forename: Frank L
authors.initials: FL
authors.lastname: Rice
authors.forename: Michael C
authors.initials: MC
authors.lastname: Rowbotham
authors.forename: Karin L
authors.initials: KL
authors.lastname: Petersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006562:Herpes Zoster / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D010147:Pain Measurement / Q000379:methods / Q000639:trends*
keywords: Capsaicin response test; Chronic pain; Postherpetic neuralgia; Quantitative sensory testing; Thermal