The following article is part of coverage from the American Academy of Dermatology’s Annual Meeting (AAD 2020). Because of concerns regarding the coronavirus disease 2019 (COVID-19) pandemic, all AAD 2020 sessions and presentations were transitioned to a virtual format. While live events will not proceed as planned, readers can click here to view more news related to research presented during the AAD VMX 2020 virtual experience.


Patients with chronic inflammatory skin diseases (CISD) are at increased risk for significant morbidity from herpes zoster, according to study results presented at the American Academy of Dermatology’s Virtual Meeting Experience (AAD VMX) 2020, held online from June 12 to 14, 2020.

Data were abstracted from the 2002-2012 Nationwide Inpatient Sample, a cross-sectional cohort of 20% of all inpatient hospitalizations in the United States (n=68,088,221). Databases were searched for a primary diagnosis of herpes zoster and a secondary diagnosis of any CSID. Patients with a primary hospitalization for herpes zoster were compared with control patients hospitalized for any other reason. Within the herpes zoster cohort, patients with and without CSIDs were compared. Multivariable logistic regression models were used to assess the relationship hospitalization for herpes zoster and CSIDs. Results were expressed as odds ratios (ORs) with 95% confidence intervals [CIs]. Models were adjusted for relevant covariates, including age, sex, race/ethnicity, insurance status, and corticosteroid use.

Of the total cohort, 116,351 were hospitalized with a primary diagnosis of herpes zoster. Compared with control patients hospitalized for other reasons, patients with herpes zoster were older, more likely to be women, and more often non-White (all P <.0001). Long-term systemic corticosteroid use was more frequent in patients hospitalized for herpes zoster compared with control patients (P <.0001). In adjusted regression models, hospitalization for herpes zoster was significantly associated with several CSIDs, including atopic dermatitis (OR [95% CI]: 1.38 [1.14-1.68]), psoriasis (4.78 [2.83-8.08]), pemphigus (1.77 [1.01-3.12]), mycosis fungoides (3.79 [2.55-5.65]), dermatomyositis (7.31 [5.27-10.12]), systemic sclerosis (1.92 [1.47-2.53]), cutaneous lupus erythematosus (1.94 [1.10-3.44]), vitiligo (2.00 [1.04-3.85]), and sarcoidosis (1.52 [1.22-1.90]).  Sensitivity analyses stratified by age revealed similar trends. Length of stay and cost of hospital care for herpes zoster were significantly higher in patients with CSIDs compared with patients without.


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Per these findings, patients with CSIDs may benefit from earlier vaccination for herpes zoster to avoid complications and hospitalizations. Further study is necessary to identify appropriate means of intervention. Vaccination before the age of 50 may be appropriate in patients with CSIDs and other risk factors, authors wrote.

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Reference

Chovatiya R, Silverberg JI. Chronic inflammatory skin diseases are associated with herpes zoster in United States inpatients. Presented at: AAD VMX 2020; June 12-14, 2020. Abstract/Poster #14992.