Herpes zoster-associated voiding dysfunction in hematopoietic malignancy patients

Authors

  • Shinichi Imafuku MD, PhD,

    1. From the Division of Dermatology and Hematology, Hiroshima Red Cross and Atomic Bomb Survivor's Hospital, and Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
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  • Masakazu Takahara MD,

    1. From the Division of Dermatology and Hematology, Hiroshima Red Cross and Atomic Bomb Survivor's Hospital, and Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
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  • Takeshi Uenotsuchi MD,

    1. From the Division of Dermatology and Hematology, Hiroshima Red Cross and Atomic Bomb Survivor's Hospital, and Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
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  • Koji Iwato MD, PhD,

    1. From the Division of Dermatology and Hematology, Hiroshima Red Cross and Atomic Bomb Survivor's Hospital, and Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
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  • Masutaka Furue MD, PhD

    1. From the Division of Dermatology and Hematology, Hiroshima Red Cross and Atomic Bomb Survivor's Hospital, and Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
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Shinichi Imafuku, md, phd 3-1-1, Maidahsi Fukuoka city 812-8582 Japan
E-mail: dermatologist@mac.com

Abstract

Background  Voiding dysfunction is a rare but important complication of lumbo-sacral herpes zoster. Although the symptoms are transient, the clinical impact on immunocompromised patients cannot be overlooked.

Methods  To clarify the time course of voiding dysfunction in herpes zoster, 13 herpes zoster patients with voiding dysfunction were retrospectively analyzed.

Results  Of 13 patients, 12 had background disease, and six of these were hematopoietic malignancies; four of these patients were hematopoietic stem cell transplant (HSCT) recipients. Ten patients had sacral lesions, two had lumbar, and one had thoracic lesions. Interestingly, patients with severe rash, or with hematopoietic malignancy had later onset of urinary retention than did patients with mild skin symptoms (Mann–Whitney U analysis, P = 0.053) or with other background disease (P = 0.0082). Patients with severe skin rash also had longer durations (P = 0.035). In one case, acute urinary retention occurred as late as 19 days after the onset of skin rash.

Conclusions  In immune compromised subjects, attention should be paid to patients with herpes zoster in the lumbo-sacral area for late onset of acute urinary retention even after the resolution of skin symptoms.

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