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.
Herpes zoster is an acute , localized infection with varicella-zoster virus, which causes a painful, blistering rash. After the initial exposure, herpes zoster lies dormant in certain nerve fibers.Whereas varicella is generally a disease of childhood, herpes zoster and postherpetic neuralgia become more common with increasing age. Following resolution of the chickenpox, the virus lies dormant in the dorsal root ganglia until focal reactivation along a ganglion's distribution results in herpes zoster (shingles). Historically, it was thought that shingles incidence increased due to an age-related decline in immunity; however, recent studies suggest that incidence of shingles is linked to the reduced frequency of periodic exogenous (outside) exposures to children with varicella (chickenpox) due to the increasing vaccination of that population. A temporary weakness in immunity (the body's ability to fight infection) may cause the virus to multiply and move along nerve fibers toward the skin. Eye problems caused by severe or chronic outbreaks of herpes zoster may include: glaucoma , cataract , double vision, and scarring of the cornea and eyelids This condition is known as zoster sine herpete and may be more complicated, affecting multiple levels of the nervous system and causing multiple cranial neuropathies, polyneuritis, myelitis , or aseptic meningitis. Medical treatments like chemotherapy or radiation for cancer, drugs taken to prevent rejection of transplanted organs, and cortisone taken for a long time, can make someone susceptible.
Herpes zoster , commonly known as shingles, is caused by the same virus responsible for chicken pox. It may become active as a result of many factors such as: aging, stress, suppression of the immune system, and certain medications. Although the exact precipitants that result in viral reactivation are not known certainly, decreased cellular immunity appears to increase the risk of reactivation. Herpes zoster manifests as a vesicular rash, usually in a single dermatome. Factors that decrease immune function, such as human immunodeficiency virus infection, chemotherapy, malignancies and chronic corticosteroid use, may also increase the risk of developing herpes zoster. These exposures produced an immunologic boost that helped suppress the reactivation of shingles. Shingles incidence is high in the elderly (over 60), as well as in any age group of immunocompromised patients Although children can get zoster, it is more common in people over the age 50. Illness, trauma, and stress may also trigger zoster. This acutely painful phase usually lasts several weeks; however, some continue to experience pain or neuralgia long after the outbreak has cleared.
Causes of Herpes Zoster
The common Causes of Herpes Zoster :
- The exact mechanism of varicella-zoster reactivation is not known; however, decreased cellular immunity is a causative factor.
- Herpes zoster (shingles) is caused by the chicken-pox virus.
- Usually the cause is a decrease in your body's natural resistance, which may come through other infections, stress, being generally run down, or occasionally, when the body's immune defences are affected by certain drugs or other immune deficiencies.
- The immune system is also weakened by certain diseases like cancer and HIV and by certain medications like chemotherapy, corticosteroids and drugs to prevent rejection of organ transplants.
- After having chickenpox the virus lies dormant in the nerves, and shingles occurs when it is revitalised in one particular nerve to the skin, thus explaining the way it affects a clearly demarcated band of skin only.
Symptoms of Herpes Zoster
Some common Symptoms of Herpes Zoster :
- Reddening of the skin (erythema) followed by the appearance of blisters (vesicles)
- Grouped, dense, deep, small blisters that ooze and crust
- Many patients mistakenly believe that "nervousness" causes shingles. this is wrong; shingles is a viral infection of a nerve and has nothing to do with being "nervous."
- The most common sites of shingles are on one side of the chest (front or back, like half of a belt) and on one side of the forehead and scalp .
- Fever, chills
- Lymph node swelling
- Joint pain
- 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.
Treatment of Herpes Zoster
Here is the list of the methods for treating Herpes Zoster :
- Even taking acyclovir may not eliminate discomfort, burning sensations, or pain if the discomfort is mild, take Tylenol or a similar mild painkiller.
- Initial therapy may include nonsteroidal anti-inflammatory drugs (NSAIDs).
- Lotions (ie, Calamine) may help relieve discomfort.
- The blistering rash usually clears in a few weeks the discomfort may persist longer.
- The main thing is to take regular pain relief (an analgesic), possibly even better an anti-inflammatory pain killer ( non steroidal anti-inflammatory drug ), as long as these do not upset you or interact with any medications you may be taking.
- In many cases, narcotic analgesia is necessary.
- In the event of long-lasting pain (post herpetic neuralgia) you should consult further with your doctor, who may try alternative treatments, and sometimes may ask a pain specialist to see you.
- Later, when the crusts and scabs are separating, your skin may become dry, tense, and cracked if that happens, rub on a small amount of white petrolatum (plain Vaseline) three or four times a day.