[Full text] Herpes zoster in psoriasis patients undergoing treatment with biologic | PTT

Conclusion and recommendations

Concerning HZ in psoriasis patients receiving biologicals, the following statements are proposed:

• Psoriasis does not confer a specific higher risk of HZ compared to the other inflammatory joint and intestinal diseases.
• The administration of biologicals in these patient groups increases the incidence of HZ by twofold to threefold.
• In patients treated with biologicals, one may expect HZ in younger age groups compared to common HZ.
• One should be more vigilant for a possible diagnosis of HZ in the first year after the instauration of a biological therapy.
• HZ is usually not different from common HZ in the immunocompetent population.
• Very severe and extensive cases of HZ are rare in these patient groups.
• In the case of HZ, look for risk factors for severe HZ, especially satellite lesions and severe prodromal pains.
• Antiviral treatment and management of HZ in psoriasis patients under biologicals are not different compared to their nonimmuncompromised counterparts.
• Intravenous ACV treatment is recommended for severe cases of HZ.
• If possible, the HZ LAVV vaccine should be administered before starting biologicals in patients never having experienced HZ previously.
• When commercially available, the new subunit HZ vaccine should be provided before or during biological treatments in patients never having experienced HZ previously.

https://www.dovepress.com/herpes-zoster-in-psoriasis-patients-undergoing-treatment-with-biologic-peer-reviewed-fulltext-article-PTT

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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