| 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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