Shingles (Herpes Zoster)

Shingles is a neuropathic condition that really lives up to its name. Shingles is also known as Herpes Zoster and provides a characteristic painful skin rash in the affected nerve area (dermatome).

The diagnosis is due to a reactivation of the chickenpox virus called Varicella zoster. The condition can cause severe nerve pain and is due to the virus physically traveling through the nerves to the nerve endings in the skin - and causing infectious blisters (which can cause chickenpox to someone who has not had it - it can not be infected with shingles).

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In the article, we will review:

• Symptoms of shingles

• The reason you get shingles

• Treatment of herpes zoster

      + Medicines for shingles

      + Herpes zoster vaccine

In this article you can learn more about shingles and the cause of the diagnosis, symptoms, prevention, diagnosis and treatment of this clinical condition.

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Symptoms of Shingles (Herpes Zoster)

The condition usually starts by experiencing that an area of ​​the skin is sore or that it dots in the skin. This may persist for about two to four days before a rash is formed there. In some, these pains can be severe and cause nerve pain that follows the entire affected nerve.

The previous, nonspecific symptoms of shingles can include headaches, mild fever and fatigue. Before the symptoms turn to more specific symptoms - such as:

• Burning pain

• Hypersensitive skin

• Itching

• Numbness

• tingling

• Sharp, rising nerve pain along the nerve root

It is important to note that shingles affect a single dermatoma (an area innervated by a single nerve) and only one side of the body. This means that the rash will only occur in this area - which is characteristic and unique to shingles.

For example, shingles in the C8 nerve root may cause a rash down the arm, but primarily in one lower half of the hand (see illustration). The rash will gradually break down and disappear. But in some more serious cases, it can leave physical scars.

Source: Birgitte Lerche-Barlach.

The most common condition is that the condition hits the chest or face. But the diagnosis can in theory occur in any dermatome - including:

• The eye

• Ear

• mouth

• Tongue

We will go into this in more detail in the article.

Diagnosis of herpes zoster

Since the clinical presentation and rash are so unique (dermatologically conditioned), only a visual examination from the doctor is normally required to establish the diagnosis. But there are also laboratory tests such as the Tzank test that can help identify the disease.

Varying Pain from Person to Person

It is important to remember that shingles can affect to varying degrees and strengths in different people. Some people may have significant, severe nerve pain - where others only have a certain discomfort in the affected nerve area approximately as at the diagnosis stress neck.

The condition usually persists for between two and four weeks - but in some people it can linger for several months. If this happens it is known as post herpetic neuralgia.

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Shingles in the Face and the Eye

Herpes zoster can also hit a dermatoma of the face. The trigeminal nerve is the most vulnerable when it comes to outbreaks of shingles on the face.

A branch of this nerve is called the ophthalmic nerve. If herpes zoster occurs in this nerve rash (zoster ophthalmic) then severe symptoms may occur - which in the worst case can lead to damage to vision. With this diagnosis, the rash can occur on the forehead, on the eyelid or in the eye socket itself.

Zoster ophthalmosis accounts for about 10-25% of shingles outbreaks - and can, as said, lead to serious visual complications in the form of inflammation (uveitis, keratitis, conjunctivitis) or nerve damage to the optic nerve. These complications can cause chronic optic inflammation, poor vision and severe pain.

Shingles in the Ear and Mouth

If shingles occur in the ear, the medical name is Ramsay Hunt Syndrome type 2. This diagnosis can occur if the virus spreads from the facial nerve (cerebral nerve number seven) to the vestibulocochlear nerve. Symptoms may include hearing loss and vertigo (rotational dizziness).

The mouth can also be affected by herpes zoster if the nerve branching of the nerve maxillarius or the nerve mandibularis of the trigeminal nerve is affected. In these cases, the rash may occur inside the mouth - for example in the palate, mouth, tongue or gums.

Shingles in the mouth is relatively rare - which means that patients often mistakenly think that it is tooth-related and thus consult a dentist. Without it helping.

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Cause: Why are shingles affected?

Re-activation of the chickenpox virus is particularly linked to weakened immune systems, that you are of a higher age, and that you had chickenpox before you turned 18 months.

Even in our modern times, it is not entirely certain how the chickenpox virus remains in the body - or how it is reactivated. What is known, however, is that it is due to the varicella zoster virus - which is related to the herpes simplex, but not the same virus. The virus enters the body when you are affected by chickenpox. Usually at a young age.

A reactivation of the varicella zoster virus can be practically only caused by a weakening of the immune system. If the immune system is strong and activated as normal then this should prevent shingles outbreaks and the characteristic rashes.

However, there are several factors that can cause a temporarily reduced immune system - this may include:

• Cell poisoning or radiation therapy

• Long-term illness

• Medicinal side effects

Who is affected by shingles?

Research has shown that as many as a third of us are affected by a case of shingles. The diagnosis is thus relatively common.

Fortunately, the condition does not, normally, occur several times during the life of an individual. In fact, only about 5% of those affected will experience this.

The risk of being affected by shingles increases with age. Especially those over 65 who have also weakened immune systems appear to be the ones most frequently affected.

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Prevention and Treatment of Shingles

In this section of the article we will give you more information on how vaccination can work against herpes zoster - and which drugs are used against this diagnosis.

Vaccine against Shingles

There are several different vaccines that can be used to reduce the risk of being affected by shingles. Research has shown that these can be very effective - with efficiencies of between 50-90%.

Vaccines can also reduce the incidence of post-herpes neuralgia, and if shingles occur anyway, reduce both its duration and intensity.

Medicines and medicines for shingles

If you are affected by shingles, then you should know that there is drug treatment that can help relieve both the symptoms and the intensity of the pain.

Anti-viral drugs, such as acyclovir, used against certain viral infections (including shingles) - and has a clinically proven effect if used within 72 hours of the rash appearing.

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Summarizeringing

Shingles is a painful diagnosis that causes a rash within the affected dermatome (nerve area). The condition is relatively common and affects around 33% of us. A strong immune system is the best way to prevent the condition from occurring, but there are also effective vaccines for those with weakened immune systems.

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