Efficacy of Narrow Band UVB in combination with oral acyclovir versus oral acyclovir alone in prevention of post herpetic neuralgia in patients with herpes zoster
Abstract
Background Post-herpetic neuralgia (PHN) is one of the serious complications of herpes zoster and response to available treatment/s is unsatisfactory. A few studies have shown promising effects of narrow band ultraviolet B (NBUVB) in combination with acyclovir in the prevention of PHN. The aim of this study was to determine the efficacy of combination of NBUVB and acyclovir in prevention of PHN in patients with herpes zoster.
Patients and Methods A randomized controlled trial was conducted at Dermatology unit, Fauji Foundation Hospital, Rawalpindi. 60 Patients (age>30years) with herpes zoster were enrolled. The study group (A) was treated with NBUVB; three times a week for a maximum of 15 sessions or before if the pain had completely settled and oral acyclovir (800mg five times a day for 10 days). The control group (B) was treated with only oral acyclovir (800mg five times a day for 10 days). Pain severity was assessed on 4-point verbal rating scale (VRS) before starting treatment, at completion of treatment and 3 months after the end of the trial. The efficacy of treatment was complete pain relief (0-score on VRS) after a 03 month follow up period.
Results After a 03 month follow up period, in group A, 24 patients (92.3%) had complete pain relief while in group B, only 2 patients (7.7%) had achieved the same score. The prevention of PHN was significantly lower (p < 0.000) in the control group.
Conclusion NBUVB with oral acyclovir is more effective than oral acyclovir alone in the prevention of PHN in patients of herpes zoster .