To investigate the clinical characteristics of Korean patients with facial herpes zoster.

The present study enrolled patients with facial involvement among the patients with herpes zoster. The percentage of involved branches of the trigeminal nerve, types and frequency of ocular complications, and changes in visual acuity depending on systemic treatment were analyzed.

A total of 146 patients (15.9%) out of 916 patients with herpes zoster were diagnosed with facial herpes zoster. The ophthalmic branch was the most frequently involved (55.5%), and coinfection with the ophthalmic and maxillary branch was also common (31.5%). Ocular complications developed in 82 eyes (56.2%) and were most common in the group of coinfection with the ophthalmic and maxillary branch (Fisher's exact test, p =0.003). Conjunctivitis (72.0%) was the most commonly observed ocular complication, while punctate keratitis and endothelitis were also frequent. After treatment with a systemic antiviral agent, visual acuity was significantly improved (paired t test, p =0.001).

A higher incidence of ophthalmic complications was observed in facial herpes zoster patients with a wider area of involvement, including the ophthalmic branch. There was significant improvement of visual acuity and ocular complications after systemic treatment. Therefore, systemic antiviral treatment should be considered when a broad herpes zoster skin lesion is observed.