Shingles Health Article

Definition

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.

Description

Any individual who has had chickenpox can develop shingles. Approximately 300,000 cases of shingles occur every year in the United States. Overall, approximately 20% of those who had chickenpox as children develop shingles at some time in their lives. People of all ages, even children, can be affected, but the incidence increases with age. Newborn infants, bone marrow and other transplant recipients, as well as indivduals with immune systems weakened by disease or drugs are also at increased risk. However, most individuals who develop shingles do not have any underlying malignancy or other immunosuppressive condition.

Causes and symptoms

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 lain 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, either as a result of stress, fatigue, certain medications, chemotherapy, or diseases, such as cancer or HIV. Further, it can be an early sign in persons with HIV that the immune system has deteriorated.

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