Shingles: 10-year evolution of patient characteristics, clinical manifestations, therapeutic approach and complications.

Background: Shingles has long been known to doctors, but its incidence seems to be increasing. Data regarding the evolution of shingles in the last decade are lacking. Objectives: To characterize demographic, clinical and prognostic outcomes of shingles and compare the results between two samples 10 years apart. Methods: This was a cohort study that used retrospective data collected from patients admitted to the Dermatology Emergency Room (DER) of a tertiary hospital in Lisbon, Portugal, with a diagnosis of shingles from May 2012 to May 2013 and from March 2022 to March 2023. Collected data included date of admission, demographics, medical history, clinical characteristics, treatment and complications. Results: Of the 474 patients (232 from 2012-2013 and 242 from 2022-2023) there was no seasonal or sex preference. Median age was 58 years. Patients from 2022-2023 had more autoimmune diseases, immunosuppressant use, chronic obstructive pulmonary disease and chronic cutaneous diseases, and a higher tendency for neoplastic disease. HIV infection was similar in both groups and higher than in the general population. Almost 20% of patients had pain as the first symptom. V1 was the most affected dermatome, followed by T4-T5. The most common complications were postherpetic neuralgy (PHN), ocular complications and bacterial overinfection. PHN and bacterial overinfection were more prevalent in 2022-2023. Conclusions: During a 10-year interval, the number of patients diagnosed with shingles in the DER remained stable, with no differences found regarding age and sex. The 2022-2023 group had more comorbidities and complications. HIV and neoplastic disease were risk factors for the occurrence of shingles.