Shingles

General Illness Information

Common Name:
Shingles

Medical Term: Herpes Zoster

Description:

Reactivation of a latent or dormant virus (varicella,or chickenpox virus)  in the body.

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.

Can affect any age, but most common in adults over the age of 50.

Causes:

Herpes zoster is caused by the varicella-zoster virus, the same virus that causes chickenpox. It may lie dormant in the spinal cord until triggered by risk factors. Not all the risk factors are known.

Prevention:

Cannot be prevented at present.

Signs & Symptoms

  • Painful red blisters anywhere on the body. Blisters appear 4 to 5 days after early symptoms begin.( Chills, fever, malaise, nausea and diarrhea)
  • 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.
  • Chest pain, face pain, or burning pain in the skin of the abdomen, depending on the affected area.

Risk Factors

  • Adults over 50.
  • Use of immuno-suppressive or anti-cancer drugs.
  • Illness that has lowered resistance (HIV infection etc.)
  • Hodgkin’s disease.
  • Spinal surgery or radiation.
  • Leukemia or lymphoma.

Diagnosis & Treatment

General Measures:

  • Diagnosis is usually not possible until rash appears. Before then, the symptoms may mimic viral illness, appendicitis, pleurisy or other conditions.
  • Diagnostic tests may include laboratory blood tests and culture of fluid from blister, and skin biopsy (rare).
  • 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.
  • When bathing, wash blisters gently.
  • Don’t bandage the sores.
  • Apply cool, moist compresses if this decreases the pain.
  • Soak in a tub of water to which cornstarch or colloidal oatmeal has been added.

Medications:

  • Calamine lotion for the blisters.
  • For minor discomfort, you may use non-prescription drugs such as acetaminophen.
  • Stronger pain relievers if needed.
  • Tranquilizers for a short time.
  • Anti-viral drugs may be prescribed. For immunocompromised patients, intravenous acyclovir may be useful.
  • Injections of nerve block may be recommended in severe cases.

Activity:

No restrictions.

Diet:

No special diet.

Possible Complications :

  • Secondary infection in the herpes zoster blisters.
  • Chronic pain, especially in the elderly, that persists for months or years in the sensory nerves where the blisters have been (post herpetic neuralgia).
  • Corneal ulceration.

Prognosis

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.