Clinical and epidemiological aspects of herpes zoster disease in a primary care setting in Riyadh, Saudi Arabia: A retrospective cohort study

CONTEXT: Herpes zoster (HZ), or shingles, is one of the most common infectious diseases. HZ can be associated with other diseases, such as cancer and immunocompromised conditions. Thus, early recognition of the disease characteristics and clinical manifestations is critical to decrease the disease burden and to avoid further complications. AIM: To assess the epidemiology of HZ disease, its clinical manifestations, coexisting and post-existing conditions, complications, and management among patients in a primary care setting. SUBJECTS AND METHODS: This was a retrospective, single-armed, cohort study. Data of all patients diagnosed with HZ, aged 18 years and older, who visited the Family Medicine Department at King Faisal Specialist Hospital and Research Center from January 2014 to August 2021 were reviewed from their medical records. All data analyses were performed using IBM Statistical Package for the Social Sciences (SPSS) statistical software, version 20.0. RESULTS: A total of 330 cases were included over the study period. The male-to-female ratio was 1:2, with a higher occurrence of HZ (44.5%) in those aged ≥ 50 years. Only 4.5% of the patients were recipients of zoster vaccines. Thoracic dermatome was the most affected dermatome (38%). The most common coexisting disease was diabetes (21.5%). The most common post-existing disease was cardiovascular disease (3%), and the most common complication was postherpetic neuralgia (15.2%). Suboptimal dosage of acyclovir was the most commonly used treatment for HZ infections (69.7%). CONCLUSIONS: Zoster vaccination uptake was low. A national program for adult vaccination, including zoster vaccination, should be developed, and a guideline to direct primary health-care professionals in the management of HZ infections should be implemented.