INTRODUCTION
Zona zoster is a painful disease with dermatomal localized vesicles. It
is a disease that can cause significant acute morbidity and long-term
sequelae, including chronic pain, which can seriously impair the quality
of life even in those receiving appropriate antiviral therapy. Zona
zoster occurs following a decrease in cell-mediated immunity specific to
varicella zoster virus (VZV), and therefore the risk of zona zoster
among individuals with impaired cell-mediated immune function is
increased [1,2]. The most important risk factor for zona zoster is
advanced age. Aging reduces the skin’s ability to synthesize vitamin D,
and increased skin pigmentation reduces the effectiveness of UVB to
stimulate vitamin D synthesis [3,4].
Cell mediated immunity is known to decrease with age, and decreased cell
mediated immunity is associated with reactivation of VZV [5].
Vitamin D is important for calcium homeostasis, bone health, and
prevention of fractures. Vitamin D has effects on metabolic, neoplastic,
inflammatory, and immune events [6,7]. Vitamin D deficiency is
considered to be a serum 25-hydroxyvitamin D (25-OH-D) level of less
than 20 ng / ml. 25-OH-D vitamin values between 20 and 30 ng / ml are
considered insufficient and are considered clinically important. The
prevalence of vitamin D deficiency varies according to geographic
regions with different levels of sunlight exposure [7,8]. It has
been found that vitamin D deficiency is frequently seen in various viral
infectious diseases. Vitamin D affects the secretion of antimicrobial
peptides associated with several toll-like receptors (TLRs) that have
antiviral effects. Similarly, 1,25- (OH) 2-D strongly
stimulated the release of human cathelicidins from neutrophils and
possibly monocytes and natural killer cells. Human cathelicidin is
induced by TLR1 / 2 activation and contributes to mucosal immunity and
provides antiviral effects [7,8]. There are few publications on the
relationship between vitamin D levels and zona zoster. Chao et al.
suggested that vitamin D may affect both human susceptibility to
varicella zoster virus and the clinical course of zona zoster [8].
In this study, we aimed to compare the vitamin D level in zona zoster
patients with that of healthy controls and to investigate the possible
role of vitamin D level in the development of zona zoster.