Shingles (Herpes Zoster) : Articles

Herpes zoster (shingles) is a painful, blistering skin rash due to acute infection with the varicella-zoster virus, the virus that causes chickenpox. See also: Ramsay Hunt syndrome

Shingles, also called herpes zoster, gets its name from both the Latin and French words for belt or girdle and refers to girdle-like skin eruptions that may occur on the trunk of the body. The virus that causes chickenpox , the varicella zoster virus (VSV), can become dormant in nerve cells after an episode of chickenpox and later reemerge as shingles. Initially, red patches of rash develop into blisters. Because the virus travels along the nerve to the skin, it can damage the nerve and cause it to become inflamed. This condition can be very painful. If the pain persists long after the rash disappears, it is known as post-herpetic neuralgia .

Shingles, also called herpes zoster, gets its name from both the Latin and French words for belt or girdle and refers to girdle-like skin eruptions that may occur on the trunk of the body. The virus that causes chickenpox , the Varicella zoster virus (VSV), can become dormant in nerve cells after an episode of chickenpox and later re-emerge as shingles. Initially, red patches of rash develop into blisters . Because the virus travels along the nerve to the skin, it can damage the nerve and cause it to become inflamed. This condition can be very painful. If the pain persists long after the rash disappears, it is known as post-herpetic neuralgia (PHN).

Chicken pox (varicella) is a highly infectious, acute viral illness caused by the varicella zoster virus. The illness is characterized by a generalized pruritic, vesicular rash with fever and systemic symptoms usually lasting from seven to ten days. In the pre-immunization era in the United States, there were approximately 4 million cases, 11,000 hospitalizations, and 100 deaths every year. Most cases occurred in children under ten years of age. Complications from chicken pox include pneumonia, encephalitis, cerebellar ataxia, infections, and bleeding disorders. Infants, adults, and immunocompromised persons are at higher risk of severe disease, hospitalization, and death. Once a person recovers from chicken pox, the virus stays in the body for life (becomes latent), residing in nerve cells known as dorsal root ganglia. The virus can reactivate, resulting in herpes zoster (shingles), which usually presents as a band-like rash in an area of the body that receives innervation from one sensory nerve. Approximately 15 percent of persons who have had chicken pox will develop shingles at some point in their lives, the risk increasing with advancing age. Most cases are associated with a vesicular rash, though some affected persons experience local pain as well. However, persons older than fifty years may develop a severe pain syndrome lasting for months known as post-herpetic neuralgia. In 1995, a live, attenuated vaccine was licensed in the United States for routine childhood immunization against chicken pox. Since then, the number of cases of chicken pox has decreased significantly. Another vaccine has been tested for prevention or modification of shingles. K ARIN G ALIL J ANE S EWARD ( SEE ALSO : Communicable Disease Control ; Immunizations )

Herpes zoster, also called shingles, and referred to as "zosteer", gets its name from both the Latin and French words for belt or girdle and refers to belt-like skin eruptions that may occur on the trunk of the body. The virus Shingles, or herpes zoster, on patient's buttocks and thigh. ( Custom Medical Stock Photo . Reproduced by permission .) that causes chickenpox, the varicella zoster virus (VSV), can become dormant in nerve cells after an episode of chickenpox and later re-emerge as shingles. Any individual who has had chickenpox can develop shingles. People of all ages, even children, can be affected, but the incidence increases with age. There are many other conditions which can predispose to developing shingles. These include: newborn infants, bone marrow and other transplant recipients, and individuals with immune systems weakened by diseases like HIV or cancer, or drugs, such as those used in chemotherapy . Shingles erupts along the course of the affected nerve, producing lesions anywhere on the body and may cause severe nerve pain. The most common areas to be affected are the face and trunk, which correspond to the areas where the chickenpox rash is most concentrated. The disease is caused by a reactivation of the chickenpox virus that has been dormant in certain nerves following an episode of chickenpox. Exactly how or why this reactivation occurs is not clear; however, it is believed that the reactivation is triggered when the immune system becomes weakened as in the examples described above. Early signs of shingles are often vague and can easily be mistaken for other illnesses. The condition may begin with fever and malaise (a vague feeling of weakness or discomfort). Within two to four days, severe pain, itching , and numbness/tingling (paresthesia) or extreme sensitivity to touch (hyperesthesia) can develop, usually on the trunk and occasionally on the arms and legs. Pain may be continuous or intermittent, usually lasting from one to four weeks. It may occur at the time of the eruption, but can precede the eruption by days, occasionally making the diagnosis difficult. Signs and symptoms may include the following: itching, tingling, or severe burning pain red patches that develop into blisters grouped, dense, deep, small blisters that ooze and crust swollen lymph nodes Immunocompromised patients usually have a more severe course that is frequently prolonged for weeks to months. They develop shingles frequently and the infection can spread to the skin, lungs, liver, gastrointestinal tract, brain, or other vital organs. Potentially serious complications can result from herpes zoster. Many individuals continue to experience persistent pain long after the blisters heal. This pain, called post-herpatic neuralgia, can be severe and debilitating. Post-herpetic neuralgia can persist for months or years after the lesions have disappeared. Other complications include a secondary bacterial infection, and rarely, potentially fatal inflammation of the brain (encephalitis) and the spread of an infection throughout the body. These rare, but extremely serious, complications are more likely to occur in those individuals who have weakened immune systems (immunocompromised).

Shingles is infection by the varicella-zoster virus of the dorsal root ganglia of the spine. Equivalent terms for shingles are herpes zoster, zoster, zona, or acute posterior ganglionitis.