| General Illness Information |
Common Name: |
Shingles |
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Medical Term:
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Herpes Zoster |
| Description: |
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Reactivation of a latent
or dormant virus (varicella,or chickenpox virus) in
the body.
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When the virus is
activated, it spreads through part of the nervous system
called the dorsal root ganglia, causing the characteristic
crops of blistering lesions (vesicles) of shingles.
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Can affect any age, but
most common in adults over the age of 50.
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| Causes: |
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Herpes zoster is caused
by the varicella-zoster virus, the same virus that causes
chickenpox.
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It may lie dormant in
the spinal cord until triggered by risk factors. Not all the
risk factors are known.
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| Prevention: |
Cannot be prevented at present. |
| Signs
& Symptoms |
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Painful red blisters
anywhere on the body. Blisters appear 4 to 5 days after
early symptoms begin.( Chills, fever, malaise, nausea
and diarrhea)
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The blisters appear
on a broad streak of reddened skin along sensory-nerve
routes to a particular area of skin. They occur most
often on the chest, or face and spread only on one side
of the body.
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Chest pain, face
pain, or burning pain in the skin of the abdomen,
depending on the affected area.
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| Risk Factors |
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Adults over 50.
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Use of immuno-suppressive
or anti-cancer drugs.
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Illness that has lowered
resistance (HIV infection etc.)
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Hodgkin's disease.
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Spinal surgery or
radiation.
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Leukemia or lymphoma.
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| Diagnosis & Treatment |
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| General
Measures: |
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Diagnosis is
usually not possible until rash appears. Before then,
the symptoms may mimic viral illness, appendicitis,
pleurisy or other conditions.
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Diagnostic tests
may include laboratory blood tests and culture of
fluid from blister, and skin biopsy (rare).
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Primary goal of
treatment is to relieve the itching and pain as much
as possible, usually with topical and oral
medications. The nerve pain (post-herpetic neuralgia)
that lingers after the skin clears is the most
difficult to treat, and unfortunately, there are no
therapies at present to prevent it.
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When bathing, wash
blisters gently.
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Don't bandage the
sores.
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Apply cool, moist
compresses if this decreases the pain.
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Soak in a tub of
water to which cornstarch or colloidal oatmeal has
been added.
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| Medications: |
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Calamine lotion for
the blisters.
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For minor
discomfort, you may use non-prescription drugs such as
acetaminophen.
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Stronger pain
relievers if needed.
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Tranquilizers for a
short time.
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Anti-viral drugs may
be prescribed. For immunocompromised patients,
intravenous acyclovir may be useful.
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Injections of nerve
block may be recommended in severe cases.
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| Activity: |
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No restrictions
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| Possible
Complications : |
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Secondary
infection in the herpes zoster blisters.
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Chronic pain,
especially in the elderly, that persists for months or
years in the sensory nerves where the blisters have
been (post herpetic neuralgia).
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Corneal
ulceration.
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| Prognosis |
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The rash usually clears in 14 to 21 days. The
nerve pain may last for another month or longer. One attack usually
provides immunity against herpes zoster, but occasionally a few
persons have had more than one attack of herpes zoster.
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