Inflammatory skin diseases may be associated with herpes zoster hospitalization risk

A study presented at the American Academy of Dermatology virtual meeting associated several risk factors for herpes zoster hospitalization in those with chronic inflammatory skin diseases.

“Nearly one in three people in the U.S. will develop herpes zoster in their lifetime, with approximately 1 million cases annually and a 3% hospitalization rate,” Raj Chovatiya, MD, PhD, and Jonathan I. Silverberg, MD, PhD, MPH, wrote. “Patients with chronic inflammatory skin diseases have potential risk factors for HZ, including long-term use of systematic immunosuppressants and immune dysregulation in the skin and periphery.”

The researchers examined data from the 2002 to 2012 Nationwide Inpatient Sample, a cross-sectional cohort representing hospitalizations of 68,088,22 children and adults in the United States. ICD-9-CM codes were used to identify primary diagnosis of herpes zoster and secondary diagnosis of chronic inflammatory skin diseases.

Chovatiya and Silverberg identified an association between several chronic inflammatory skin diseases and patients who were hospitalized with herpes zoster (mean age, 65.7 years; 61.9% female; 71.7% white).

There was a greater length of stay for patients with chronic inflammatory skin diseases such as atopic dermatitis, pemphigus, bullous pemphigoid, mycosis fungoides and Sezary syndrome. Patients with diagnoses of pemphigus, bullous pemphigoid, sarcoidosis, systematic sclerosis and pyoderma gangrenosum saw increased costs for care.

In patients with chronic inflammatory skin diseases, herpes zoster hospitalization was associated with female sex and extensive use of corticosteroids and inversely associated with increased number of chronic conditions and early adult age, Chovatiya and Silverberg wrote.

Increased vaccination for herpes zoster may benefit patients with chronic inflammatory skin diseases, especially if they are younger than 50 years old and have risk factors, they said.