한국인 안면부 대상포진 환자의 임상양상

목적: 안면부 대상포진의 한국인에서의 임상양상을 알아보고자 한다. 대상과 방법: 대상포진 환자 중 안면부 병변을 보였던 환자를 대상으로 삼차신경 분지의 침범 비율, 안과적 합병증의 종류와 발생빈도, 전신치료여부에 따른 합병증 빈도와 시력 변화에 대해 조사하였다. 결과: 대상포진 환자 916명 중 안면부 대상포진으로 진단 받은 환자는 146명(15.9%)이었다. 삼차신경 중 안분지가 55.5%로 침범비율이 가장 높았으며 안분지와 상악골분지가 함께 침범된 경우가 31.5% 이었다. 안과적 합병증은 82안(56.2%)에서 발생하였고, 안분지와 상악골분지가 함께 감염되었을 때 빈도가 가장 높았다(Fisher`s exact test, p=0.003). 합병증은 결막염이 72.0%로 가장 흔하였고, 점상각막염, 내피세포염 순이었다. 전신치료군은 치료 후 시력이 호전되었다(paired t-test, p=0.001). 결론: 안면 대상포진 환자에서 안분지를 포함한 침범영역이 넓을수록 안과적 합병증의 빈도가 높았다. 전신 항바이러스제 치료 후 시력과 합병증이 호전되었다. 따라서 안면부 대상포진 환자가 넓은 병변을 보일수록 전신적인 항바이러스제 투여가 고려되어야겠다. Purpose: To investigate the clinical characteristics of Korean patients with facial herpes zoster. Methods: The present study enrolled patients with facial involvement among the patients with herpes zoster. The percentage of involved branches of the trigeminal nerve, types and frequency of ocular complications, and changes in visual acuity depending on systemic treatment were analyzed. Results: A total of 146 patients (15.9%) out of 916 patients with herpes zoster were diagnosed with facial herpes zoster. The ophthalmic branch was the most frequently involved (55.5%), and coinfection with the ophthalmic and maxillary branch was also common (31.5%). Ocular complications developed in 82 eyes (56.2%) and were most common in the group of coinfection with the ophthalmic and maxillary branch (Fisher`s exact test, p=0.003). Conjunctivitis (72.0%) was the most commonly observed ocular complication, while punctate keratitis and endothelitis were also frequent. After treatment with a systemic antiviral agent, visual acuity was significantly improved (paired t test, p=0.001). Conclusions: A higher incidence of ophthalmic complications was observed in facial herpes zoster patients with a wider area of involvement, including the ophthalmic branch. There was significant improvement of visual acuity and ocular complications after systemic treatment. Therefore, systemic antiviral treatment should be considered when a broad herpes zoster skin lesion is observed. J Korean Ophthalmol Soc 2010;51(1):8-13