Postherpetic pruritus an underreported complication of herpes zoster infection: A case report and literature review
DOI:
https://doi.org/10.66344/jpad.v32i2.1884Abstract
Postherpetic pruritus (PHP) is a complication of herpes zoster infection that is not commonly reported. However, some cases describe severe disabling postherpetic pruritus. PHP may become unnoticed and thus inadequately managed. A 66-year-old woman complained of intense pruritus on the lower back and buttocks area one month after herpes zoster infection appeared at that location. Gabapentin 300 mg once a day was prescribed and the pruritus sensation was significantly reduced. Few studies report the epidemiology, clinical presentation, and standard treatment of PHP. It can happen alone or in combination with postherpetic neuralgia. The pathophysiology of PHP remains to be determined. Disability and injury may happen as a consequence of PHP. There are several treatments suggested for PHP but all are limited to case reports. PHP is an underreported complication of herpes zoster that must be taken seriously. Our case was an elderly woman diagnosed with PHP. She suffered moderate pruritus which disturbed intensely her quality of life and was improved significantly with gabapentin.
References
1. Hadley GR, Gayle JA, Ripoll J, Jones MR, Argoff CE, Kaye RJ. Post-herpetic neuralgia: A review. Curr Pain Headache Rep. 2016;20(3):17.
2. Shimada N, Niwa Y, Hotta K, Igarashi T, Takeuchi M. Pregabalin for postherpetic itch: a case report. JA Clin Rep. 2020;6(1):24.
3. Hassan S, Cohen PR. Postherpetic pruritus: a potential complication of herpes zoster virus infection. Cureus. 2019;11(9):e5665.
4. Oaklander AL, Bowsher D, Galer B, Haanpaa M, Jensi MP. Herpes zoster Itch: preliminary epidemiologic data. J Pain. 2003;4(6):338-43.
5. Mittal A, Srivastava A, Balai M, Khare AK. A study of postherpetic pruritus. Indian Dermatol Online. 2016;7(4):343-4
6. Semionov V, Shvartzman P. Post herpetic itching-a treatment dilemma. Clin J Pain. 2008;24(4):366-8.
7. Oaklander AL. Mechanisms of pain and itch caused by herpes zoster (shingles). J Pain. 2008;9:S10-8.
8. Koshy E, Mengting L, Kumar H, Jianbo W. Epidemiology, treatment and prevention of herpes zoster: a comprehensive review. Indian J Dermatol Venereol Leprol. 2018;84(3):251-62.
9. Jagdeo J, Kroshinky D. A case of post-herpetic itch resolved with gabapentin. J Drugs Dermatol. 2011;10(1):85-8.
10. Griffin JR, Davis MDP. Amitriptyline/Ketamine as therapy for neuropathic pruritus and pain secondary to herpes zoster. J Drugs Dermatol. 2015;14(2):115-8.
11. Ding DF, Li RC, Xiong QJ, Zhou L, Xiang HB. Pulsed radiofrequency to the great occipital nerve for the treatment of intractable postherpetic itch: a case report. Int J Clin Med. 2014;7(10):3497-500.
12. Peterson RC, Patel L, Cubert K, Gulati A. Serial stellate ganglion blocks for intractable postherpetic itching in a pediatric patient: a case report. Pain Physician. 2009;12(3):629-32.
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Copyright (c) 2022 Kara Adistri, Shannaz Nadia Yusharyahya, Lili Legiawati, Rinadewi Astriningrum, Dina Kusumawardhani
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