The Effects of Early Corticosteroid Therapy on the Skin Eruption and Pain of Herpes Zoster

The Effects of Epidural Blockade on the Acute Pain in Herpes Zoster

“…1,2 Thus, PHN is difficult to manage and, unfortunately, refractory to most forms of treatment modalities. It has been demonstrated that antiviral treatment, [3][4][5][6] cortcosteroids, 7,8 sympathetic and regional nerve blockade, 9,10 and a combination of these therapies 11,12 in the early stage of disease have preventive effects on PHN and reduce the duration of acute pain in HZ. Early therapeutic interventions with antiviral drags, particularly newly developed drugs, such as valacyclovir hydrochloride and famciclovir, allowed dramatic improvements of the skin lesions of HZ and reductions in the incidence of PHN.…”

Tumescent Infiltration of Corticosteroids, Lidocaine, and Epinephrine Into Dermatomes of Acute Herpetic Pain or Postherpetic Neuralgia

“…[5][6][7] More recently, the number of physicians prescribing oral corticosteroids during the acute phase of herpes zoster outbreak has been reduced because of negative study results, 8 the lack of randomized controls, and the fear of dissemination of herpes zoster virus in immunocompromised hosts. The recent introduction of potent antiviral medications has shown some efficacy in reducing the frequency of postherpetic neuralgia.…”

How should zoster trials be conducted?

“…Pain which persists beyond healing of the rash is one such definition (Watson et al, 1988), whereas others have suggested that only patients whose pain continues beyond some arbitrary cut-off point (such as 30 days or 2 months from rash onset) have PHN (Sauer, 1955;Eaglstein, Katz & Brown, 1970). Given its uncertain definition, estimates of the incidence of PHN have varied.…”