Araştırma Makalesi
Yıl 2022,
, 417 - 424, 12.09.2022
Öz
Amaç: Herpes Zoster, Varisella Zoster Virüsünün reaktivasyonu sonucunda meydana gelen, dermatomal dağılım gösteren veziküller ile karakterize bir hastalıktır. İleri yaşlarda ve immünosupresyonu olan çocuklarda daha sık görülmektedir. Bu çalışma Herpes Zoster tanılı çocukların klinik özelliklerini ve predispozan faktörleri değerlendirmek için tasarlanmıştır.
Gereç ve Yöntem: Ocak 2015 Mart 2021 tarihleri arasında hastanemiz Dermatoloji Polikliniğine başvuran ve Herpes Zoster tanısı alan 16 yaş altı hastaların bilgileri retrospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, şikâyetleri, şikâyetlerinin süresi, suçiçeği aşıları, suçiçeği öyküleri, ek sistemik hastalıkları, eşlik eden viral enfeksiyonlar ve diğer predispozan faktörler belirlendi. Ek olarak döküntünün dermatomal yayılımı, uygulanan tedaviler ve komplikasyonlar gözden geçirildi.
Bulgular: Çalışmaya alınan 67 olgunun 44’ü (%65,7) erkek, 23’ü (%34,3) kadın idi. Hastaların yaş ortalaması 9,7 ± 2,9 yıl idi. En sık görülen şikâyet lezyon bölgesinde kaşıntı idi (%44,8). En sık tutulan dermatom torakal dermatom idi (%56,7). Hiçbir hastada immünosupresyon veya malignite saptanmadı. İki vakada konjonktivit ve üç vakada sekonder bakteryel enfeksiyon gelişmişti. En sık saptanan predispozan faktör: Stres (%38,8) faktörü idi.
Sonuç: Herpes Zoster, çocuklarda altta yatan bir immünosupresyonun veya malignitenin kutanöz göstergesi olmayıp klinik olarak iyi bir seyir izlemektedir. Hastalık daha çok stres, viral enfeksiyonlar ve güneş maruziyeti gibi predispozan faktörler eşliğinde karşımıza çıkmaktadır.
Anahtar Kelimeler
Kaynakça
- Kennedy P, Gershon A. Clinical Features of Varicella Zoster Virus Infection. Viruses. 2018; 10 (11): 609.
- Leung AKC, Robson WLM, Leong AG. Herpes zoster in childhood. J Pediatr Health Care. 2006; 20 (5): 300 3.
- Feder HM, Hoss DM. Herpes zoster in otherwise healthy children. Pediatr Infect Dis J. 2004; 23 (5): 451 7
- Sauve RS, Leung AKC. Congenital varicella syndrome with colonic atresias. Clin Pediatr. 2003; 42 (5): 451 3.
- Weinmann S, Naleway AL, Koppolu P, Baxter R, Belongia EA, Hambidge SJ. Incidence of Herpes Zoster Among Children: 2003 2014. Pediatrics. 2019; 144 (1).
- Takayama N, Takayama M, Takita J. Herpes zoster in healthy children immunized with varicella vaccine. Pediatr Infect Dis J. 2000; 19 (2): 169 70.
- Grote V, Von KR, Rosenfeld E, Belohradsky BH, Liese J. Immunocompetent children account for the majority of complications in childhood herpes zoster. J Infect Dis. 2007; 196 (10): 1455 8.
- Topkarcı Z, Erdoğan B, Erkum T, Yılmaz M. Sağlıklı çocuklarda herpes zoster infeksiyonu. Bakirkoy. 2012; 178 81.
- Tepe B, Bucak İH, Almış H. Herpes Zoster in Healthy Children: A Retrospective Study. Turk J Dermatol. 2016; 10 (2): 65 9.
- Moodley A, Swanson J, Grose C, Bonthius DJ. Severe Herpes Zoster Following Varicella Vaccination in Immunocompetent Young Children. J Child Neurol. 2019; 34 (4): 184 8.
- Guffey DJ, Koch SB, Bomar L, Huang WW. Herpes Zoster Following Varicella Vaccination in Children. Pediatric Dermatology. :5.
- Weinmann S, Chun C, Schmid DS, Roberts M, Vandermeer M, Riedlinger K. Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, 2005 2009. J Infect Dis. 2013; 208 (11): 1859 68.
- Arısoy ES, Çiftçi E, Hacımustafaoğlu M, Kara A, Kuyucu N, Somer A. Clinical Practical Recommendations for Turkish National Vaccination Schedule for Previously Healthy Children (National Vaccination Schedule) and Vaccines not Included in the Schedule 2015. J Pediatr Inf. 2015; 9 (1): 1 11.
- Marra F, Parhar K, Huang B, Vadlamudi N. Risk Factors for Herpes Zoster Infection: A Meta Analysis. Open Forum Infectious Diseases. 2020; 7 (1): 5.
- Arvin AM, Pollard RB, Rasmussen LE, Merigan TC. Cellular and humoral immunity in the pathogenesis of recurrent herpes viral infections in patients with lymphoma. J Clin Invest. 1980; 65 (4): 869 78.
- Hata A, Asanuma H, Rinki M, Sharp M, Wong RM, Blume K. Use of an inactivated varicella vaccine in recipients of hematopoietic cell transplants. N Engl J Med. 2002; 347 (1): 26 34.
- Zawitkowska J, Lejman M, Szmydki Baran A, Zaucha Prażmo A, Czyżewski K, Dziedzic M. Varicella zoster virus infection in the pediatric population with acute lymphoblastic leukemia in Poland. Journal of Medical Virology. 2020; 92 (12): 3645 9.
- Kim B S, Mehra S, Yawn B, Grose C, Tarrell R, Lahr B, vd. Increased risk of herpes zoster in children with asthma: a population based case control study. J Pediatr. 2013; 163 (3): 816 21.
- Wi C I, Kim B S, Mehra S, Yawn BP, Park MA, Juhn YJ. Risk of herpes zoster in children with asthma. Allergy Asthma Proc. 2015; 36 (5): 372 8.
- Jc F, Hh M, Mp F, Nw G, Mt T, Rm P. Herpes zoster infection in childhood onset systemic lupus erythematosus patients: a large multicenter study. Lupus. 2016; 25 (7).
- Kamboj A, Hwang CJ, Mokhtarzadeh A, Harrison AR. Development of Herpes Zoster Ophthalmicus in an Immunocompetent Pediatric Patient Following Facial Trauma. Ophthalmic Plast Reconstr Surg. 2021; 37 (5): 170 2.
- Ashi A, Ali A, Alzahrani M, Ali J, Albar R. Herpes Zoster Eruption in an Otherwise Healthy Child: A Case Report. Cureus. 2019; 11 (7): 5194.
- Socan M, Blaško M. Surveillance of varicella and herpes zoster in Slovenia, 1996 2005. Eurosurveillance. 2007;12(2):13 4.
- Zak Prelich M, Borkowski JL, Alexander F, Norval M. The role of solar ultraviolet irradiation in zoster. Epidemiol Infect. 2002; 129 (3): 593 7.
- Gupta MA, Gupta AK. Herpes zoster in the medically healthy child and covert severe child abuse. Cutis. 2000; 66 (3): 221 3.
- Harpaz R, Leung JW, Brown CJ, Zhou FJ. Psychological Stress as a Trigger for Herpes Zoster: Might the Conventional Wisdom Be Wrong? Clinical Infectious Diseases. 2015;60(5):781 5.
- Çölgeçen E, Küçük Ö, Balcı M. Çocukluk Çağı Herpes Zoster İnfeksiyonun Klinik Özellikleri. Turkderm. 2012; 46 (1): 26 8.
- Pona A, Jiwani RA, Afriyie F, Labbe J, Cook PP, Mao Y. Herpes zoster as a potential complication of coronavirus disease 2019. Dermatol Ther. 2020; 33 (6): 13930.
- Elsaie ML, Nada HA. Herpes zoster (shingles) complicating the course of COVID19 infection. J Dermatolog Treat. 2020; 1 3.
- Elsaie ML, Youssef EA, Nada HA. Herpes zoster might be an indicator for latent COVID 19 infection. Dermatol Ther. 2020; 33 (4): 13666.
- Nikkels AF, Nikkels Tassoudji N, Piérard GE. Revisiting childhood herpes zoster. Pediatr Dermatol. 2004; 21 (1): 18 23.
- Giehl KA, Müller Sander E, Rottenkolber M, Degitz K, Volkenandt M, Berking C. Identification and characterization of 20 immunocompetent patients with simultaneous varicella zoster and herpes simplex virus infection. J Eur Acad Dermatol Venereol. 2008; 22 (6): 722 8.
- Aktaş H, Erdal SA, Güvenç U. Herpes Zoster in children: Evaluation of the sixty cases. Dermatologic Therapy. 2021; 32 (6).
- Solomon AR. New diagnostic tests for herpes simplex and varicella zoster infections. J Am Acad Dermatol. 1988; 18 (2): 218 21.
- Straus SE, Oxman MN. Varicella and Herpes Zoster. Dermatology in General Medicine’de. Ed. Fitzpatrick TB, Eisen AZ, Wolf K ve ark. 5. Baskı. New York, McGraw Hill Book Company, 1999: 2427 50.
- Werth VP, White WL, Sanchez MR, Franks AG. Incidence of alopecia areata in lupus erythematosus. Arch Dermatol. 1992; 128 (3): 368 71.
- Goh CL, Khoo L. A retrospective study of the clinical presentation and outcome of herpes zoster in a tertiary dermatology outpatient referral clinic. Int J Dermatol. 1997; 36 (9): 667 72.
- Kanamori K, Shoji K, Kinoshita N, Ishiguro A, Miyairi I. Complications of herpes zoster in children. Pediatrics International. 2019; 61 (12): 1216 20.
- Karagün E. Childhood Herpes Zoster Infection: A Retrospective Study. Turk J Dermatol. 2019; 13 (1): 20 4.
- Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, vd. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007; 44: 1 26.
- 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 (10): 1268 72.
Yıl 2022,
, 417 - 424, 12.09.2022
Öz
Aim: Herpes Zoster is a disease characterized by vesicles with dermatomal distribution, resulting from the reactivation of the Varicella Zoster Virus. It is more common in older ages and in children with immunosuppression. This study was designed to evaluate the clinical features and predisposing factors of children diagnosed with Herpes Zoster.
Materials and Methods: Data of the patients under 16 years of age that were diagnosed with Herpes zoster at our dermatology outpatient clinic were retrospectively evaluated between January 2015 and March 2021. Patients' age, gender, complaints, duration of complaints, varicella vaccines, chickenpox history, additional systemic diseases, accompanying viral infections and other predisposing factors were determined. In addition, dermatomal extent of the rash, treatments and complications were reviewed.
Results: Out of 67 cases enrolled in the study; 44 (65.7%) were male and 23 (34.3%) were female. The mean age of the patients was 9.7 ± 2.9 years. The most common complaint was itching in the lesion area (44.8%). The most frequently involved dermatome was thoracic dermatome (56.7%). Immunosuppression or malignancy was not detected in any patient. Conjunctivitis developed in two cases and secondary bacterial infection in three cases. The most common predisposing factor was stress (38.8%).
Conclusion: Herpes zoster is not a cutaneous indicator of an underlying immunosuppression or malignancy in children and has a good clinical course. The disease is mostly accompanied by predisposing factors such as stress, viral infections and sun exposure.
Anahtar Kelimeler
Kaynakça
- Kennedy P, Gershon A. Clinical Features of Varicella Zoster Virus Infection. Viruses. 2018; 10 (11): 609.
- Leung AKC, Robson WLM, Leong AG. Herpes zoster in childhood. J Pediatr Health Care. 2006; 20 (5): 300 3.
- Feder HM, Hoss DM. Herpes zoster in otherwise healthy children. Pediatr Infect Dis J. 2004; 23 (5): 451 7
- Sauve RS, Leung AKC. Congenital varicella syndrome with colonic atresias. Clin Pediatr. 2003; 42 (5): 451 3.
- Weinmann S, Naleway AL, Koppolu P, Baxter R, Belongia EA, Hambidge SJ. Incidence of Herpes Zoster Among Children: 2003 2014. Pediatrics. 2019; 144 (1).
- Takayama N, Takayama M, Takita J. Herpes zoster in healthy children immunized with varicella vaccine. Pediatr Infect Dis J. 2000; 19 (2): 169 70.
- Grote V, Von KR, Rosenfeld E, Belohradsky BH, Liese J. Immunocompetent children account for the majority of complications in childhood herpes zoster. J Infect Dis. 2007; 196 (10): 1455 8.
- Topkarcı Z, Erdoğan B, Erkum T, Yılmaz M. Sağlıklı çocuklarda herpes zoster infeksiyonu. Bakirkoy. 2012; 178 81.
- Tepe B, Bucak İH, Almış H. Herpes Zoster in Healthy Children: A Retrospective Study. Turk J Dermatol. 2016; 10 (2): 65 9.
- Moodley A, Swanson J, Grose C, Bonthius DJ. Severe Herpes Zoster Following Varicella Vaccination in Immunocompetent Young Children. J Child Neurol. 2019; 34 (4): 184 8.
- Guffey DJ, Koch SB, Bomar L, Huang WW. Herpes Zoster Following Varicella Vaccination in Children. Pediatric Dermatology. :5.
- Weinmann S, Chun C, Schmid DS, Roberts M, Vandermeer M, Riedlinger K. Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, 2005 2009. J Infect Dis. 2013; 208 (11): 1859 68.
- Arısoy ES, Çiftçi E, Hacımustafaoğlu M, Kara A, Kuyucu N, Somer A. Clinical Practical Recommendations for Turkish National Vaccination Schedule for Previously Healthy Children (National Vaccination Schedule) and Vaccines not Included in the Schedule 2015. J Pediatr Inf. 2015; 9 (1): 1 11.
- Marra F, Parhar K, Huang B, Vadlamudi N. Risk Factors for Herpes Zoster Infection: A Meta Analysis. Open Forum Infectious Diseases. 2020; 7 (1): 5.
- Arvin AM, Pollard RB, Rasmussen LE, Merigan TC. Cellular and humoral immunity in the pathogenesis of recurrent herpes viral infections in patients with lymphoma. J Clin Invest. 1980; 65 (4): 869 78.
- Hata A, Asanuma H, Rinki M, Sharp M, Wong RM, Blume K. Use of an inactivated varicella vaccine in recipients of hematopoietic cell transplants. N Engl J Med. 2002; 347 (1): 26 34.
- Zawitkowska J, Lejman M, Szmydki Baran A, Zaucha Prażmo A, Czyżewski K, Dziedzic M. Varicella zoster virus infection in the pediatric population with acute lymphoblastic leukemia in Poland. Journal of Medical Virology. 2020; 92 (12): 3645 9.
- Kim B S, Mehra S, Yawn B, Grose C, Tarrell R, Lahr B, vd. Increased risk of herpes zoster in children with asthma: a population based case control study. J Pediatr. 2013; 163 (3): 816 21.
- Wi C I, Kim B S, Mehra S, Yawn BP, Park MA, Juhn YJ. Risk of herpes zoster in children with asthma. Allergy Asthma Proc. 2015; 36 (5): 372 8.
- Jc F, Hh M, Mp F, Nw G, Mt T, Rm P. Herpes zoster infection in childhood onset systemic lupus erythematosus patients: a large multicenter study. Lupus. 2016; 25 (7).
- Kamboj A, Hwang CJ, Mokhtarzadeh A, Harrison AR. Development of Herpes Zoster Ophthalmicus in an Immunocompetent Pediatric Patient Following Facial Trauma. Ophthalmic Plast Reconstr Surg. 2021; 37 (5): 170 2.
- Ashi A, Ali A, Alzahrani M, Ali J, Albar R. Herpes Zoster Eruption in an Otherwise Healthy Child: A Case Report. Cureus. 2019; 11 (7): 5194.
- Socan M, Blaško M. Surveillance of varicella and herpes zoster in Slovenia, 1996 2005. Eurosurveillance. 2007;12(2):13 4.
- Zak Prelich M, Borkowski JL, Alexander F, Norval M. The role of solar ultraviolet irradiation in zoster. Epidemiol Infect. 2002; 129 (3): 593 7.
- Gupta MA, Gupta AK. Herpes zoster in the medically healthy child and covert severe child abuse. Cutis. 2000; 66 (3): 221 3.
- Harpaz R, Leung JW, Brown CJ, Zhou FJ. Psychological Stress as a Trigger for Herpes Zoster: Might the Conventional Wisdom Be Wrong? Clinical Infectious Diseases. 2015;60(5):781 5.
- Çölgeçen E, Küçük Ö, Balcı M. Çocukluk Çağı Herpes Zoster İnfeksiyonun Klinik Özellikleri. Turkderm. 2012; 46 (1): 26 8.
- Pona A, Jiwani RA, Afriyie F, Labbe J, Cook PP, Mao Y. Herpes zoster as a potential complication of coronavirus disease 2019. Dermatol Ther. 2020; 33 (6): 13930.
- Elsaie ML, Nada HA. Herpes zoster (shingles) complicating the course of COVID19 infection. J Dermatolog Treat. 2020; 1 3.
- Elsaie ML, Youssef EA, Nada HA. Herpes zoster might be an indicator for latent COVID 19 infection. Dermatol Ther. 2020; 33 (4): 13666.
- Nikkels AF, Nikkels Tassoudji N, Piérard GE. Revisiting childhood herpes zoster. Pediatr Dermatol. 2004; 21 (1): 18 23.
- Giehl KA, Müller Sander E, Rottenkolber M, Degitz K, Volkenandt M, Berking C. Identification and characterization of 20 immunocompetent patients with simultaneous varicella zoster and herpes simplex virus infection. J Eur Acad Dermatol Venereol. 2008; 22 (6): 722 8.
- Aktaş H, Erdal SA, Güvenç U. Herpes Zoster in children: Evaluation of the sixty cases. Dermatologic Therapy. 2021; 32 (6).
- Solomon AR. New diagnostic tests for herpes simplex and varicella zoster infections. J Am Acad Dermatol. 1988; 18 (2): 218 21.
- Straus SE, Oxman MN. Varicella and Herpes Zoster. Dermatology in General Medicine’de. Ed. Fitzpatrick TB, Eisen AZ, Wolf K ve ark. 5. Baskı. New York, McGraw Hill Book Company, 1999: 2427 50.
- Werth VP, White WL, Sanchez MR, Franks AG. Incidence of alopecia areata in lupus erythematosus. Arch Dermatol. 1992; 128 (3): 368 71.
- Goh CL, Khoo L. A retrospective study of the clinical presentation and outcome of herpes zoster in a tertiary dermatology outpatient referral clinic. Int J Dermatol. 1997; 36 (9): 667 72.
- Kanamori K, Shoji K, Kinoshita N, Ishiguro A, Miyairi I. Complications of herpes zoster in children. Pediatrics International. 2019; 61 (12): 1216 20.
- Karagün E. Childhood Herpes Zoster Infection: A Retrospective Study. Turk J Dermatol. 2019; 13 (1): 20 4.
- Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, vd. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007; 44: 1 26.
- 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 (10): 1268 72.
Toplam 41 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Eylül 2022 |
| Gönderilme Tarihi | 22 Eylül 2021 |
| Yayımlandığı Sayı | Yıl 2022 |
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