Population-based study of herpes zoster and its sequelae.

The epidemiology of herpes zoster and its sequelae have been investigated in a community-based study. The incidence rates observed in Rochester, Minnesota, are lower than those determined in practice-based series; and this may reflect some selectivity in practice-based series compared to population-based studies. No significant sex difference or seasonal variation was observed but the incidence did increase markedly with age. An increase in incidence was also observed over the 15-year period studied. The dermatomal distribution of herpes zoster observed in Rochester was quite similar to previous studies, despite their inherent biases in case ascertainment, except for a lower proportion with cranial nerve zoster. Herpes ophthalmicus (V1) appears to affect a slightly different population than zoster of the other dermatomes, with elderly males being more at risk. Also, herpes ophthalmicus is associated with a higher complication rate compared to the other dermatomes primarily due to the fragility of the involved organ. The elderly are also at greatest risk for the most common complication, post-herpetic neuralgia. The rate of PHN is not significantly increased in any particular dermatome but is significantly decreased in lumbar herpes zoster.