HERPES ZOSTER

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Last Updated : 6/2/2009
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Dr. Ira Shah
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What is herpes zoster?
Herpes zoster is a skin rash that occurs due to varicella zoster virus (the same virus that causes chicken pox). A person acquires chicken pox usually during childhood, which is a self-limiting disease most of the time. This virus then remains dormant in nerve cells of the body for months to years and may again reactivate during adulthood to cause herpes zoster also known as shingles.

Who are the patients at risk for getting herpes zoster?
Herpes zoster occurs in patients who have a decrease in body's resistance power. With decreasing immunity, the virus reactivates, begins to multiply and then moves along the nerve fibres towards the skin. It is commonly seen in elderly people as their immune system weakens. Other patients at risk are cancer patients on chemotherapy or radiotherapy, patients with organ transplant and HIV infected patients.

How does herpes zoster present?
2-3 days prior to the skin rash, patients may have burning pain or tingling in one area of the skin, which is usually on one side of body. This is followed by appearance of blisters on a red base again in same area of skin. These blisters last for two to three weeks, during which pus may appear, then they crust and finally begin to disappear leaving behind a depigmented area on the skin (Figure 1). The pain may last longer and sometimes pain is severe enough to require painkillers.




The common areas to be involved are trunk, buttocks, genitalia or face. If it involves the eye, eye damage can result.

What are the complications of shingles?
- The rash usually disappears leaving a scar. Scarring may be severe in elderly persons, in those whom blisters become infected or those who have used chemicals to treat themselves.
- Post-herpetic neuralgia is constant nerve pain that may occur in older patients in which pain persists for a long time after the skin has healed.
- In few patients, the disease can spread leading to infection of various organs of the body.

Is shingles contagious?
Shingles is less contagious than chicken pox. However, direct contact with the blisters and broken skin is to be avoided

How is herpes zoster treated?
Treatment consists of painkillers, cool compresses and antiviral drug called 'acyclovir'. The drug can stop progression of shingles if taken early in disease process but does not prevent post-herpetic neuralgia.

Since the virus remains dormant in the nerve cells, it may recur once the immune system again weakens. However, recurrence is very rare.



Contributor Information and Disclosures Dr. Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India


First Created : 2/5/2001
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