Shingles

Shingles, or herpes zoster, occurs when the dormant chickenpox virus, varicella zoster, is reactivated in nerve tissues. Early signs of shingles include tingling and localized pain.

Although shingles can occur anywhere on the body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of the torso.

Shingles are caused by the varicella-zoster virus — the same virus that causes chickenpox. After chickenpox, the virus lies inactive in nerve tissue near the spinal cord and brain. Years later, the virus may reactivate as shingles.

While it isn’t a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.

Most, but not all, people with shingles develop a blistering rash. Also may experience itching, burning, or deep pain.

Typically, the shingles rash lasts two to four weeks, and most people make a complete recovery. Doctors are often able to quickly diagnose shingles from the appearance of the rash. It is the commonest disease in the elderly.

Approximately 1-4 percent of people who develop shingles require hospitalization for complications, and 30 percent of those have impaired immune systems.

The symptoms of shingles usually affect only a small section of one side of the body. These symptoms may include:

  • Acute pain, tingling, numbness, and itching on a specific part of the skin, on a single side of the body.
  • Between 1 and 5 days, after the pain begins, a rash appears.
  • Red blotches emerge that develop into itchy fluid-filled blisters.
  • The rash looks like chickenpox but only on the band of skin supplied by the affected nerve.
  • The rash may involve the face, eyes, mouth, and ears in some cases.
  • Sometimes, the blisters merge, forming a solid red band that looks like a severe burn.
  • In rare cases (among people with weakened immune systems) the rash may be more extensive and look similar to a chickenpox rash.
  • If shingles affect the eye, this is called optical shingles. The virus invades an ophthalmic nerve and causes painful eye inflammation and temporary or permanent loss of vision.
  • New blisters may appear for up to a week.
  • Inflammation might be caused in the soft tissue under and around the rash.
  • People with lesions on the torso may feel spasms of pain at the gentlest touch.
  • The blisters will gradually dry up and form scabs or crusts within 7-10 days. At this point, the rash is no longer considered infectious.
  • Minor scarring may occur where the blisters have been.
  • A shingles episode normally lasts 2-4 weeks.

In some cases, there is a rash but no pain, or no visible rash but a band of pain.

Other symptoms include fever, headache, malaise, nausea, muscle pain and weakness, chills, upset stomach, difficulties with urination, fatigue, joint pain, swollen lymph nodes.

Rarely, shingles can lead to pneumonia, brain inflammation, or encephalitis, or death. This usually happens in people who have an impaired immune system.

If the rash affects areas of the face, symptoms may include difficulty moving some facial muscles, drooping eyelids, hearing loss, loss of eye motion, problems with taste, vision problems.

Varicella-zoster (shingles) virus belongs to a group of viruses called herpes-viruses.

Shingles are caused by the same virus that is responsible for chickenpox. After recovering from chickenpox, the virus may remain in the body. It lies dormant in the central nervous system (CNS).

All herpes viruses can hide in the nervous system, where they can remain almost indefinitely. Under the suitable conditions, the herpes zoster virus can reactivate, or wake up from hibernation, and travel down nerve fibers to cause a new active infection.

In most cases, it is not clear why the varicella-zoster virus begins multiplying to cause shingles.

Some people notice when something weakens the immune system, prompting the virus to reactivate. The reason for shingles is unclear. Possible triggers include:

  • Older age.
  • Some diseases, including certain cancers and HIV or AIDS.
  • Cancer treatments, such as chemotherapy and radiation therapy, as these lower a person’s resistance to disease.
  • Stress or trauma.
  • Medications, and especially immunosuppressive drugs, used by patients after an organ transplant.
  • Children who had chickenpox in infancy or whose mothers had chickenpox late in pregnancy.

There is currently no way to eliminate the shingles virus from the body. But prompt treatment with prescription antiviral drugs can speed healing and reduce risk of complications. These medications include:

  • Acyclovir (Zovirax)
  • Valacyclovir (Valtrex)

Shingles can cause severe pain, so doctor also may prescribe:

  • Capsaicin topical patch,
  • Anticonvulsants, such as gabapentin,
  • Tricyclic antidepressants, such as amitriptyline,
  • Numbing agents, such as lidocaine, delivered via a cream, gel, spray or skin patch,
  • Medications that contain narcotics, such as codeine,
  • An injection including corticosteroids and local anesthetics.

Shingles generally lasts between two and six weeks. Most people get shingles only once, but it is possible to get it two or more times.

Vaccines are available & Vaccines can prevent shingles.

Keep the rash dry and clean to reduce the risk of infection. Wear loose-fitting clothing for comfort. Taking a cool bath or using cool, wet compresses on blisters may help relieve the itching and pain. And, if possible, try to reduce the amount of stress.

Contact a doctor promptly if suspect shingles or to confirm the diagnosis, but especially in the following situations:

  • The pain and rash occur near an eye. If left untreated, this infection can lead to permanent eye damage.
  • Age 60 or older, because age significantly increases the risk of complications.
  • Who has a weakened immune system (due to cancer, medications or chronic illness)?
  • The rash is widespread and painful.
  • Oxford hand Book of Medical Dermatology
  • Roxburgh’s common skin diseases
  • Andrew’s Diseases of the skin

Shingles

TUI - Tibot Urgency Index

Shingles, or herpes zoster, occurs when the dormant chickenpox virus, varicella zoster, is reactivated in nerve tissues. Early signs of shingles include tingling and localized pain.

Although shingles can occur anywhere on the body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of the torso.

Shingles are caused by the varicella-zoster virus — the same virus that causes chickenpox. After chickenpox, the virus lies inactive in nerve tissue near the spinal cord and brain. Years later, the virus may reactivate as shingles.

While it isn’t a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.

Most, but not all, people with shingles develop a blistering rash. Also may experience itching, burning, or deep pain.

Typically, the shingles rash lasts two to four weeks, and most people make a complete recovery. Doctors are often able to quickly diagnose shingles from the appearance of the rash. It is the commonest disease in the elderly.

Approximately 1-4 percent of people who develop shingles require hospitalization for complications, and 30 percent of those have impaired immune systems.

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Dr. Lora Smith

MBBS (Dhaka), DGO (DU) Ex SR. Gynaecologist & Obstetrician

09 606 111 222

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