Age-dependent trigeminal and female-specific lumbosacral increase in herpes zoster distribution in the elderly
Age-dependent trigeminal and female-specific lumbosacral increase in herpes zoster distribution in the elderly
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DOI：
10.1016/j.jdermsci.2018.01.009
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发表时间：
2018-05-01
影响因子：
4.6
通讯作者：
Yajima, Misako
中科院分区：
文献类型：
--
作者：
Shiraki, Kimiyasu;Toyama, Nozomu;Yajima, Misako
背景资料：水痘-带状疱疹病毒引起带状疱疹（HZ）沿着特定的皮节，但年龄和性别对HZ distributions.Objective的影响：我们调查了年龄和性别依赖的HZ的分布特点。方法：患者HZ监测成员的宫崎皮肤科医师协会。收集了2730例患者的年龄、性别、皮区分布等资料和病变标本，对2508例PCR诊断病例进行了分析。HZ发生率随年龄增长而增加，约为0-29岁时皮区基本发生率的4倍;两种性别三叉神经区的发生率均增加11倍，女性胸部和腰骶部的发生率增加幅度大于男性。此外，三叉神经第一分支沿着发病率最高，这一事实表明与长期紫外线照射有关。在50-59岁的女性患者中，包括胸10-腰1/骶2-4和胸5-6的节段性皮节明显更频繁地受到影响，并且分别与分娩和母乳喂养的产科麻醉区域一致。此外，暴露于紫外线、分娩和母乳喂养可能会增加老年人特定皮区的发病率。本研究为HZ的病因学提供了重要信息。(C)2018日本皮肤病研究学会。Elsevier B. V.出版，保留所有权利。
Background: Varicella-zoster virus causes herpes zoster (HZ) along specific dermatomes, but the effects of age and sex on HZ distribution are unclear.Objective: We investigated the age- and sex-dependent distribution characteristics of HZ.Methods: Patients with HZ were monitored by members of the Miyazaki Dermatologist Society. Questionnaires containing information on age, sex, and dermatome distribution and lesion specimens from 2730 patients were collected, and 2508 PCR-diagnosed cases were analyzed.Results: The ratio of lesions in the thoracic area to lesions in the whole body decreased with age, whereas those of other areas increased. HZ incidence increased with age to about four times that of the basic incidence in the dermatome areas at age 0-29 years; the incidence in the trigeminal area in both sexes increased 11-fold, and the incidence in the thoracic and lumbosacral areas increased in females more than in males. Furthermore, the fact that the highest incidence was found along the first branch of the trigeminal nerve suggests an association with long-term ultraviolet ray exposure. Segmental dermatomes comprising thoracic 10-lumbar 1/sacral 2-4 and thoracic 5-6 were significantly more frequently affected in female patients at age 50-59 years and are consistent with areas of obstetric anesthesia for childbirth and of breastfeeding, respectively.Conclusions: HZ incidence increased with age; moreover, exposure to ultraviolet rays, childbirth, and breastfeeding might increase the incidence at specific dermatomes in older individuals. This study provides important information on the etiology of HZ. (C) 2018 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.