Risk factors associated with complications of facial herpes zoster: A single center retrospective analysis

Abstract

Risk factors associated with complications of facial herpes zoster: A single center retrospective analysis Park, Ji Hun Dept. of Medical Science The Graduate School Hanyang University Background: Herpes zoster (HZ) is a viral infection resulting from the reactivation of the varicella-zoster virus (VZV) that becomes latent in the dorsal root ganglia after varicella (chickenpox). Facial HZ poses unique challenges and complications, including post-herpetic neuralgia (PHN), ocular involvement, and cranial nerve palsies. Understanding the risk factors associated with these complications is crucial for effective management and prevention. Objective: To identify and analyze risk factors associated with complications of facial HZ, including PHN, ocular complications, and HZ oticus. Methods: A single-center retrospective cohort study was conducted on 192 patients with facial HZ who visited Hanyang University Guri Hospital between December 2020 and May 2023. Data included demographic characteristics, lesion locations, antiviral treatment timing, hospitalization, medications, comorbidities, and laboratory findings. Results: Demographic analysis revealed that 49.0% of cases had no complications, 41.1% had ocular involvement, and 9.9% had HZ oticus. Ocular complications were associated with increased hospitalization rates (p<0.001) and diabetes mellitus (p=0.048). PHN was significantly associated with age ≥ 60 years (p=0.010), administration of multiple analgesics (p=0.007), and ocular complications (mild HZO: p=0.002, severe HZO: p<0.001). Conclusions: Diabetes emerged as a significant risk factor for ocular complications, while age ≥ 60 years and initial severe pain were identified as significant risk factors for PHN. The occurrence of ophthalmic complications and their severity increased the risk of PHN. Despite study limitations, these findings underscore the importance of targeted interventions for at-risk populations to mitigate complications associated with facial HZ. Further studies are warranted to validate and extend these results. Keywords: Herpes zoster (HZ), Herpes zoster ophthalmicus (HZO), Herpes zoster oticus (HZ oticus), Ramsay-Hunt syndrome