Author Affiliations: Department of Dermatology, The Marshfield Clinic, Marshfield, Wisconsin.
Dr Fett brings up valid points that relate to promoting the herpes zoster vaccine, which has randomized controlled trials supporting its use in preventing PHN.1 We do not mean to suggest an opposition to this prevention strategy. Unfortunately, most individuals indicated to receive the herpes zoster vaccine fail to receive their vaccination to prevent herpes zoster. This is a very worthy practice gap with several barriers and strategies worth exploring, but this topic was beyond the scope of our limited commentary. Unfortunately, in this large unvaccinated population (and even in the vaccinated population), zoster still occurs. We maintain that the best available evidence now supports the use of gabapentin in otherwise healthy patients older than 50 years with herpes zoster who report a pain score greater than 5 of 10.2
Green CB, Stratman EJ. Gabapentin Not Shown to Prevent Postherpetic Neuralgia —Reply. Arch Dermatol. 2012;148(3):401-402. doi:10.1001/archdermatol.2011.2870