Vitamin D is closely linked to the clinical courses of herpes zoster: From pathogenesis to complications

Vitamin D is renowned for its pleiotropic effects, including but not limited to bone integrity, and it has assumed an important role in the current research era. As vitamin D receptors are present in a variety of human tissues, particularly immune cells, the immunomodulatory potential of vitamin D cannot be overemphasized. Herpes zoster, which presents as grouped cutaneous vesicles over dermatomes or visceral/central nervous system infection in its severe form, has a higher incidence in immune-suppressed patients. Considering the importance of vitamin D in host immunity, we hypothesize that vitamin D acts as an effect-modifier for the entire herpes zoster spectrum with regard to disease susceptibility, manifestation, efficacy of pharmacologic management, and emergent complications during treatment. Moreover, the possibility exists that vitamin D might affect the course of postherpetic neuralgia. In line with this theory, we comprehensively searched the existing herpes zoster literature and provided important insight into the relationship between the disease courses of herpes zoster and vitamin D.