A 3-year Retrospective Review of Herpes Zoster at the Department of Dermatology, Hospital Kuala Lumpur

Introduction: Herpes zoster (HZ) infection is due to reactivation of the latent varicella zoster virus, which occurs years after the primary infection. This study aims to describe the demographics, clinical characteristics and complications of HZ. Subjects and Methods: A retrospective review of HZ patients from the Dermatology clinic from January 2021 to December 2023. Results: Two hundred and twenty-one patients with clinically confirmed HZ were included in the study. More than half (55.7%) were males and 44.3% were females. The median age at presentation was 56 (interquartile range [IQR] 32.5). The majority (64.7%) of patients were Malay, 21.3% were Chinese, 9% were Indians and 5% other ethnicities. More than a quarter (27.1%) had no comorbidities, 22.6% had diabetes, 15.4% had malignancies and 4.5% had human immunodeficiency virus infection. The most common associated symptom was pain, followed by itch, which was reported in 70.1% and 33% of patients, respectively. Most (74.2%) patients presented with vesicles or bullae followed by erosions (26.2%). The median duration of symptoms before presentation was 4 days (IQR 4). A third (34.8%) of patients had multi-dermatomal involvement. The most common dermatome involved was V1 (38.5%). Complications were reported in 50.7% of patients; the most common being secondary bacterial infection (29.9%), followed by ocular involvement (20.4%) and post-herpetic neuralgia (12.2%). Most patients (81.5%) who developed post herpetic neuralgia were above 50-years-old. Most patients (94.1%) received antiviral therapy for at least 1 week. Conclusion: Complications of HZ were frequently reported in our study, which may lead to significant morbidity. Hence, there is a possible role of HZ vaccine as a preventive strategy to reduce morbidity.