Manejo actualizado del herpes zóster. Revisión sistemática

Abstract

Background: Herpes zoster (HZ), also known as shingles, occurs when the varicella-zoster virus, which remains latent in spinal ganglia or, more commonly, in cranial nerve pairs V and VII, reactivates, causing painful vesicles in dermatomal areas and cutaneous radicular pain. It is more common in elderly patients or those with a compromised immune system. Over the past six decades, there has been a fourfold increase in reported cases. This systematic review aims to describe the updated management of HZ, addressing the question: What are the current pharmacological and non-pharmacological treatments? Method: This study employs a qualitative, descriptive, and retrospective approach, following the PRISMA 2020 guidelines. The information was obtained from clinical trials, meta-analyses, scientific articles, documents, books, and chapters published within the last five years. The databases consulted included PubMed, SpringerLink, StatPearls, PLOS, IDSA, Scopus, DynaMed, SciELO, UpToDate, Wiley Online Library, Medscape, and Medigraphic. Results: Several studies and articles on managing herpes zoster with antivirals such as acyclovir, valacyclovir, and famciclovir were reviewed. Valacyclovir was highlighted for its efficacy and the importance of early initiation of therapy was emphasized. Non-pharmacological interventions, such as nerve blocks, lotions, and dressings, were also effective. Discussion: The review emphasizes the importance of a comprehensive approach incorporating pharmacological and non-pharmacological strategies. The effectiveness of antivirals, anti-inflammatory drugs, corticosteroids, analgesics, and newer interventions is underscored, as indicated by various authors and studies. Keywords: treatment, herpes zoster, pharmacological, antivirals, non-pharmacological