Herpes Zoster (HZ) is a frequent medical condition, often associated with an impact on the patients’ quality of life. Intention of this EADV project was the development of an interdisciplinary, consensus-based guideline on the management of patients who present with HZ, considering different patient populations (e.g. immunosuppressed patients, pregnant women) and different localisations (e.g. HZ ophthalmicus, HZ involving multiple dermatomes). The guideline aims at an improvement of the outcomes of acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of postherpetic neuralgia and other complications associated with HZ.
The elaboration of the guideline followed a pre-defined, structured process, and quality criteria for guidelines development as suggested by the AGREE II instrument were considered. The expert panel of the guideline involved 16 specialists from ten different European countries, including experts in dermatology, ophthalmology, otorhinolaryngology, neurology, virology/infectiology and anaesthesiology. Experts were nominated by the boards of the respective UEMS (Union Européenne des Médecins Spécialistes) medical specialties sections. To allow for consideration of the patient perspective, the steering group reinforced the expert panel members to pay particular attention to patient reported outcomes such as quality of life or alleviation of pain. Recommendations were drafted by the section authors and discussed by the expert panel under explicit consideration of different relevant aspects. During the consensus conference, recommendations for clinical practice were formally consented by the expert panel. After undergoing an extensive internal and external review process, the commissioning medical societies granted their formal approval of the guideline.
The guideline has been published in the Journal of the European Academy of Dermatology and Venereology (JEADV).1, 2 In Part 1, diagnostic means appropriate for patients who present with suspected HZ are discussed (http://onlinelibrary.wiley.com/doi/10.1111/jdv.13995/epdf). In the second part of the guideline publication, therapeutic interventions for patients with HZ are evaluated and discussed (http://onlinelibrary.wiley.com/doi/10.1111/jdv.13957/epdf). Both parts of the guideline are openly accessible. In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regards to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.
1 Werner RN, Nikkels AF, Marinović B, et al. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 1: Diagnosis. J Eur Acad Dermatol Venereol. 2017 Jan;31(1):9-19. doi: 10.1111/jdv.13995. Epub 2016 Nov 2.
2 Werner RN, Nikkels AF, Marinović B, et al. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 2: Treatment. J Eur Acad Dermatol Venereol. 2017 Jan;31(1):20-29. doi: 10.1111/jdv.13957. Epub 2016 Nov 2.
Werner, R.N., Nast, A.
Division of Evidence Based Dermatology (dEBM)
Klinik für Dermatologie, Venerologie und Allergologie
Charité Campus Mitte; Charité – Universitätsmedizin Berlin
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