What is Herpes Zoster?

HERPES ZOSTER is a sporadic disease. It is the consequence of the reactivation of latent virus from the spinal cord. This infection usually occurs in adults. It produces localized vesicular skin lesions confined to a dermatome and severe neuralgic pain in peripheral areas innervated by the nerves arising in the inflamed root ganglia. Herpes zoster results from reactivation of varicella virus that has lain dormant in the cerebral ganglia (extramedullary ganglia of the cranial nerves) or the ganglia of posterior nerve roots since a previous episode of chickenpox. It is a disease generally of the middle age and elderly and affects both sexes.

Clinical Features of Herpes Zoster

1. Acute pain 48-72 hrs precedes the appearance of the rash.
2. Unilateral vesicular (blister) eruption within a nerve area (dermatome). Common areas are the thorax and abdomen. Rarely ophthalmic(eye) branch of the trigeminal nerve is involved. Rashes continue to form for 3-5 days. The total duration of the disease is generally 7- 10 days, sometimes as long as 2-4 weeks before the skin returns to normal.

Complications of Herpes Zoster

1. Postherpetic neuralgia, which is chronic debilitating pain of the area affected, occurs commonly in elderly people.
2. Inflammation of the brain is characterised by headache, fever, vomiting and drowsiness.
3. Secondary infections of skin lesions.

Signs and symptoms of Herpes Zoster

Herpes zoster usually runs a typical course with classic signs and symptoms.

  • First, there may be burning, itching, tingling, or extreme sensitivity in one area of the skin usually limited to one side of the body. This may be present for one to three days before a red rash appears at that site.
  • The rash of shingles begins as red patches that soon develop blisters, often on one side of the body. The blisters may remain small or can become large. They heal in two to four weeks. They may leave scars.
  • Grouped, dense, deep, small blisters that ooze and crust
  • Shingles is often painful, this is because the virus travels along the nerve to get to the skin resulting in inflammation and damage to the nerve.

Management of Herpes Zoster

Prevention is uncertain. Avoid contact with the skin lesions of persons with known herpes zoster infection (shingles or chickenpox) if you have never had chickenpox or the chickenpox vaccine, or ESPECIALLY if your immune system is compromised.

The chickenpox vaccine (varicella) is a recommended childhood vaccine. The vaccine may be recommended for teenagers or adults who have never had chickenpox.

1. Bed rest.
2. Analgesics.
3. Heat in the form of hot water bottle.
4. Application of soothing liniments.
5. Consult a doctor.

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