Postherpetic neuralgia after shingles: an under-recognized cause of chronic vulvar pain

Abstract

Shingles needs to be included in the differential diagnosis of vulvar rashes because it is a modifiable risk factor for chronic vulvar pain. The possibility of postherpetic neuralgia must be considered in women with unexplained vulvar dysesthesia.

Infectious Diseases and Infestations of the Vulva

“…In the vulva, the vesicles have a short life span ending in erosions. Postherpetic neuralgia can be a debilitating sequelae of this infection [ 24 ]. Anogenital VZV infection in the pediatric population can be confused with child sexual abuse [ 25 ].…”

Natural History and Treatment of Herpes Zoster

“…6,30,49 Because herpes zoster can occur in any dermatome, it may be misdiagnosed as herpes simplex when it affects dermatomes in which such infections are common, especially lumbar, sacral, maxillary, and mandibular dermatomes. 47 In addition to involvement of the primary dermatome, patients commonly develop lesions in adjacent dermatomes. Older age is associated with a greater likelihood of a more severe herpes zoster rash, 45 but cutaneous dissemination-defined as Ͼ20 lesions outside the primary and immediately adjacent dermatomes-is rare in immunocompetent patients.…”

Pharmacological treatment of neuropathic pain in older persons

“…In a study of 916 patients with shingles, 18% of patients in their 50s experienced symptoms of post-herpetic neuralgia for 1 year or longer. However, in patients aged 70 or above this increased to 48% (Oaklander and Rissmiller 2002).…”