Herpes Zoster
Herpes Zoster is caused by Varicella-zoster
virus.
Varicella-zoster virus causes two distinct clinical
entities: varicella, or chickenpox, and herpes
zoster, or shingles. Herpes Zoster presents as a
type of skin rash accompanied by severe nerve pain.
Herpes zoster disease, is the consequence
of reactivation of latent VZV ( Varicella - zoster virus
) from the dorsal root ganglia. Herpes zoster occurs at
all ages, but its incidence is highest (5 to 10 cases per
1000 persons) among individuals in the sixth through the
eighth decades of life. It has been suggested that
approximately 2 percent of patients with herpes zoster
will develop a second episode of infection.
This disease is characterized by a one
sided vesicular eruption on the line of a nerve and is
associated with severe pain. The erythematous
maculopapular rash changes rapidly into vesicular
lesions. The onset of the disease starts usually with
severe pain on the line of the nerve that is involved
with the disease process. The eruption may remain few in
number or may continue to form for 3 to 5 days. The total
duration of disease is generally between 7 and 10 days;
however, it may take as long as 2 to 4 weeks for the skin
to return to normal.
The disease may appear practically any
place in the body. It may appear on the face (very common
), tongue, mouth, eye. Its commonly seen on the one side
of the chest.
If vesicles appear in the ear canal, and
patients lose their sense of taste in the anterior
two-thirds of the tongue while developing one sides
facial palsy.
Post Herpetic Neuralgia is the most
common complication of this disease. Its seen most in the
elderly patients or in immuno-compromised patients. This
is a very troublesome pain persisting after the
resolusion of the disease process.
Treatment
Acyclovir, 800 mg per day for 7 to
10 days. Famciclovir, Valacyclovir
are also used for herpes zoster. Other supportive
measures may also be needed to manage pain and to prevent
seconday infection of the eruptions.
Involvement of the eye needs timely care
by ophthalmologist. Eye involement can be troublesome
when cornea is involved.
Photo of Herpes Zoster Eruptions
Chickenpox
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