Hopp til innhold
NHI.no
Annonse

Prognose ved helvetesild

Innhold i artikkelen

Helvetesild er ikke en farlig eller livstruende sykdom, og tilstanden går over av seg selv. Den kan imidlertid være smertefull, og det er viktig med god smertebehandling.

Annonse

Betennelsen i huden gir sårdannelse, og hos cirka 50 prosent vil det etterlates arr eller pigmenttap av varierende omfang.

Helvetesild kan kompliseres med vedvarende smerter i måneder eller år etter sykdommen (postherpetisk nevralgi). Det er kun et fåtall som får denne tilstanden. I en studie fra Island hadde mindre enn to prosent fortsatt plager etter tre måneder. Hos pasienter eldre enn 60 år forekommer langvarige plager noe oftere, men de aller fleste er helt kvitt plagene etter seks måneder. Hos de som plages mest, kan smertene være intense, og de kan utløses av lette hudberøringer. For å forebygge denne komplikasjonen ser det ut til å være viktigst å gi god smertelindring i den akutte fasen.

Ved utbrudd i pannen er det en risiko for infeksjon og skade på øyet. Øyebetennelse med herpes zoster virus skal behandles av øyelege.

Hos personer med svekket immunforsvar kan sykdommen spre seg til indre organer og hjernen. Dette kan være en alvorlig tilstand, og ekstra intensiv behandling kan være nødvendig. Dette gjelder for eksempel pasienter med aids eller kreft.

Vil du vite mer

Vil du vite mer - Quiz

Dette dokumentet er basert på det profesjonelle dokumentet Herpes zoster . Referanselisten for dette dokumentet vises nedenfor

  1. Kofoed K, Rønholt F, Gerstoft J, Sand C. Herpes zoster: klinik, diagnostik og behandling. Ugeskr Læger 2011; 173: 114. Ugeskrift for Læger
  2. Saguil A, Kane S, Mercado M, Lauters R. Herpes zoster and postherpetic neuralgia: Prevention and management. Am Fam Physician 2017 Nov 15;96(10):656-663. PubMed
  3. Fashner J, Bell AL. Herpes zoster and postherpetic neuralgia: prevention and management. Am Fam Physician 2011; 83: 1432-7. American Family Physician
  4. Yawn BP, Saddier P, Wollan PC, et al. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc 2007; 82: 1341. PubMed
  5. Johnson BH, Palmer L, Gatwood J, et al. Annual incidence rates of herpes zoster among an immunocompetent population in the United States. BMC Infect Dis. 2015;15:502. PubMed
  6. Insinga RP, Itzler RF, Pellissier JM, et al. The incidence of herpes zoster in a United States administrative database. J Gen Intern Med 2005; 20: 748-53. PubMed
  7. Gnann JW, Whitley RJ. Herpes zoster. N Engl J Med 2002; 347: 340-6. PubMed
  8. Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 2005; 352: 2271-84. New England Journal of Medicine
  9. Wang Y-P, Liu C-J, Hu Y-W, et al. Risk of cancer among patients with herpes zoster infection: a population-based study. CMAJ 2012. doi:10.1503/CMAJ.120518 DOI
  10. Gebo KA, Kalyani R, Moore RD, Polydefkis MJ. The incidence of, risk factors for, and sequelae of herpes zoster among HIV patients in the highly active antiretroviral therapy era. J Acquir Immune Defic Syndr 2005; 40: 169. PubMed
  11. Forbes HJ, Bhaskaran K, Thomas SL, et al. Quantification of risk factors for herpes zoster: population based case-control study. BMJ 2014; 348: g2911. BMJ (DOI)
  12. Wang YP, Liu CJ, Hu YW, et al. Risk of cancer among patients with herpes zoster infection: a population-based study. CMAJ 2012 Oct 16; 184(15): E804-9. PMID: 22988158. PubMed
  13. Dworkin RH, Johnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clin Infect Dis 2007; 44 Suppl 1: S1.
  14. Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA. Prevalence of post-herpetic neuralgia after a first episode of herpes zoster: a prospective study with long term follow up. BMJ 2000; 321: 794-6. PubMed
  15. Jumaan AO, Yu O, Jackson LA, et al. Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002. J Infect Dis 2005; 191: 2002. PubMed
  16. Albrecht MA. Clinical manifestations of varicella-zoster virus infection: Herpes zoster. UpToDate, last updated Aug 02, 2016. UpToDate
  17. Albrecht MA. Treatment of herpes zoster in the immunocompetent host. UpToDate, last updated Jul 21, 2016. www.uptodate.com
  18. Berry JD, Petersen KL. A single dose of gabapentin reduces acute pain and allodynia in patients with herpes zoster. Neurology 2005; 65: 444-7. Neurology
  19. Han Y, Zhang J, Chen N, He L, Zhou M, Zhu C. Corticosteroids for preventing postherpetic neuralgia. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD005582. DOI: 10.1002/14651858.CD005582.pub4. DOI
  20. Chen N, Li Q, Yang J, et al. Antiviral treatment for preventing postherpetic neuralgia. Cochrane Database Syst Rev. 2014;2:CD006866. PMID: 24500927 PubMed
  21. Wood MJ, Shukla S, FIddian AP, Crooks RJ. Treatment of acute herpes zoster: effect of early (< 48 h) versus late (48-72 h) therapy with acyclovir and valaciclovir on prolonged pain. J Infect Dis 1998; 178 (Suppl 1): S81-S84.
  22. Pasternak B, Hviid A. Use of acyclovir, valacyklovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA 2010; 304: 859-66. Journal of the American Medical Association
  23. Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang-Xuan T. Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Br J Ophthalmol 2000; 107: 1507-11. PubMed
  24. Alper BS, Lewis PR. Does treatment of Acute Herpes Zoster Prevent or Shorten Postherpetic Neuralgia? A Systematic Review of the Literature. J Fam Pract 2000, 49;3:255-64.
  25. Gagliardi AMZ, Andriolo BNG, Torloni MR, Soares BGO. Vaccines for preventing herpes zoster in older adults. Cochrane Database of Systematic Reviews 2016, Issue 3. Art. No.: CD008858. DOI: 10.1002/14651858.CD008858.pub3 DOI
  26. Kofoed K, Rønholt F, Gerstoft J, Sand C. Forebyggelse af herpes zoster med vaccination. Ugeskr Læger 2011; 173: 110. Ugeskrift for Læger
  27. Chen N, Li Q, Zhang Y, et al. Vaccination for preventing postherpetic neuralgia. Cochrane Database of Systematic Reviews 2011; 3: CD007795. doi:10.1002/14651858.CD007795.pub2 DOI
  28. Morrison VA, Johnson GR, Schmader KE. Long-term persistence of zoster vaccine efficacy. Clin Infect Dis 2015; 60:900 DOI: 10.1093/cid/ciu918
  29. Zhang J, Xie F, Delzell E, et al. Association between vaccination for herps zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases. JAMA 2012; 308: 43-9. Journal of the American Medical Association
  30. Tseng HF, Chi M, Smith N, et al. Herpes zoster vaccine and the incidence of recurrent herpes zoster in an immunocompetent elderly population. J Infect Dis 2012; 206: 190-6. PubMed
  31. Simberkoff MS, Arbeit RD, Johnson GR, et al. Safety of herpes zoster vaccine in the Shingles Prevention Study: A randomized trial. Ann Intern Med 2010; 152: 545-54. Annals of Internal Medicine
  32. Kawai K, Preaud E, Baron-Papillon F, et al. Cost-effectiveness of vaccination against herpes zoster and postherpetic neuralgia: a critical review. Vaccine. 2014 ;32(15):1645-53. doi: 10.1016/j.vaccine.2014.01.058 DOI
  33. Forbes H, Douglas I, Finn A, et al. Risk of herpes zoster after exposure to varicella to explore the exogenous boosting hypothesis: self controlled case series study using UK electronic healthcare data. BMJ 2020; 368: l6987. pmid:31969318 PubMed
  34. Weinmann S, Chun C, Schmid DS, et al. Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, 2005-2009. J Infect Dis 2013; 208: 1859-68. doi:10.1093/infdis/jit405
  35. Breuer J, Pacoud M, Gauthier A, Brown MM. Herps zoster as a risk factor for stroke and TIA. Neurology 2014. doi:10.1212/WNL.0000000000000038 DOI
  36. Thyregod HG, Rowbotham MC, Peters M, Possehn J, Berro M, Petersen KL. Natural history of pain following herpes zoster. Pain 2007; 128: 148-156. PubMed
Annonse
Annonse