Herpes zoster infection
Herpes zoster infection, commonly known as shingles, is a painful condition characterized by a skin rash with blisters that typically appears in a band on one side of the body, often around the abdomen. This infection is caused by the varicella zoster virus, which also leads to chickenpox. After recovering from chickenpox, the virus can remain dormant in the nervous system and may reactivate later in life, primarily affecting older adults or those with weakened immune systems.
The initial symptoms of shingles often include localized pain, burning, or tingling sensations, followed by the development of red patches and fluid-filled blisters. In addition to the rash, individuals may experience fever, chills, headaches, and muscle weakness, particularly in cases where the facial nerve is affected, leading to Ramsay Hunt syndrome. Diagnosis is typically based on the symptoms and patient history, as there are no specific screening tests for shingles.
Treatment options generally involve antiviral medications to alleviate pain and hasten recovery, along with corticosteroids to reduce inflammation. Preventative measures include vaccination, which is recommended for individuals aged 60 and older, and avoiding contact with individuals who have active shingles or chickenpox. Understanding this condition can help individuals seek timely medical advice and appropriate care.
Herpes zoster infection
- ANATOMY OR SYSTEM AFFECTED: Abdomen, muscles, peripheral nervous system, skin
- ALSO KNOWN AS: Ramsay Hunt syndrome, shingles
Definition
Herpes zoster infection, or shingles, is a painful skin rash with blisters that usually occurs in a band around one side of the abdomen. Shingles occurs after a previous episode of chickenpox, a childhood disease that was especially common before the availability of a vaccination. In rare cases, shingles can affect the facial nerve and cause muscle weakness or facial paralysis; this condition is called Ramsay Hunt syndrome.
Causes
Shingles is caused by the varicella zoster virus. After infecting a person with chickenpox, the virus stays in some nerves of the body but remains dormant or inactive. There is no known reason why the virus becomes active and causes shingles.
Risk Factors
Persons who have had chickenpox may develop shingles. The risk for developing shingles, which is most common in older adults, increases with age. A weakened immune system may also create a higher risk for shingles. A weakened immune system can be caused by human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), long-term steroid use, and cancer treatments.
Symptoms
The first symptoms of shingles include pain, burning, or tingling on one side of the body from the middle of the back to the breastbone in the front. Red patches that develop into fluid-filled blisters on the skin occur in most people. The blisters eventually break and form small ulcers that dry and become crusty. These crusts fall off in two to three weeks, and scarring rarely occurs. The rash may occur on the face, ears, and mouth, and around the eyes. Additional symptoms include pain, chills, fever, difficulty moving facial muscles, headache, a general uncomfortable feeling, joint pain, swollen glands, and hearing, vision, and taste problems.
Screening and Diagnosis
There is no screening test for shingles. Diagnosis is made based on symptoms and a history of chickenpox infection. Pain on one side of the body and the telltale rash usually indicate shingles, but the examining physician may also take fluid or tissue samples from the blisters and send them to a laboratory for testing. A blood test may show an increase in white blood cells and antibodies to the varicella zoster virus, but this test does not confirm that the rash is caused by shingles.
Treatment and Therapy
Antiviral medicines in pill form or given intravenously may be prescribed to reduce pain, decrease the risk of complications, and shorten the course of the disease. Corticosteroids, such as prednisone, may be used to decrease swelling and pain. Pain medicines and antihistamines in pill or cream form may be used to reduce pain and itching. A cream containing an extract of pepper called capsaicin may be used to prevent postherpetic neuralgia, a condition in which pain and irritation persist after the blisters disappear. Soothing baths with oatmeal, calamine lotion, and cool cloths or compresses may also relieve discomfort. One should keep the rash area clean and should disinfect items used for treatment.
Prevention and Outcomes
Persons who have not had chickenpox or the chickenpox vaccine should avoid coming in contact with the rash and blisters of a person with shingles or chickenpox. For persons age sixty years and older, a herpes zoster vaccine is available that may reduce complications from shingles. The person with shingles is contagious until the blisters dry out.
Bibliography
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Steinmann, Maren, et al. "Risk Factors for Herpes Zoster Infections: A Systematic Review and Meta-Analysis Unveiling Common Trends and Heterogeneity Patterns." Infection, vol. 52, 18 Jan. 2024, pp. 1009-1026, doi.org/10.1007/s15010-023-02156-y. Accessed 4 Feb. 2025.
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