Comment on “Parabolic Changes in Pain Scores Among Partial Herpes Zoster Patients: A Retrospective Study” [Letter]

Dear editor

We read with great interest the article by Liu et al titled “Parabolic Changes in Pain Scores Among Partial Herpes Zoster Patients: A Retrospective Study”.¹ The study provides valuable insights into the unique parabolic pain trajectory observed in a subset of herpes zoster (HZ) patients and its correlation with post-herpetic neuralgia (PHN). The findings highlight the importance of early identification and intervention in patients exhibiting this pain pattern, particularly among older individuals and those with comorbidities.

However, we have a few observations and suggestions that could further enhance the study’s comprehensiveness and applicability:

Firstly, while the study identifies a significant association between the parabolic pain pattern and the development of PHN, it would be beneficial to explore potential mechanisms underlying this trajectory. Understanding the neurobiological and immunological factors that contribute to the delayed onset and escalation of pain could provide a more complete picture of the pathophysiology involved. This could include examining the role of neuroinflammation, immune response dynamics, and potential genetic predispositions.

Secondly, the study notes the high prevalence of PHN among patients with parabolic pain patterns. It would be informative to investigate whether specific interventions, such as early antiviral therapy or adjunctive analgesics, can effectively mitigate the risk of PHN in these patients. A randomized controlled trial comparing different treatment strategies could provide valuable evidence to guide clinical practice and improve patient outcomes.

Additionally, the study’s reliance on retrospective data may introduce biases related to data collection and patient recall. Future prospective studies could help validate the findings and provide more robust evidence. Incorporating a larger, multi-center sample would also enhance the generalizability of the results and allow for a broader assessment of the phenomenon across diverse populations.

Lastly, while the study focuses on the clinical implications of the parabolic pain pattern, it would be interesting to explore the psychological and social factors that may influence pain perception and management in these patients. Factors such as stress, anxiety, and social support could play a significant role in shaping the pain experience and response to treatment.

In conclusion, the work by Liu et al makes a significant contribution to our understanding of pain trajectories in HZ patients. We appreciate the authors’ efforts in highlighting the importance of early intervention and look forward to further research that addresses these points and continues to advance our knowledge in this area.