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Herpes Zoster - Definition, Causes, Symptoms and Treatment

 

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Herpes zoster is an acute, localized infection with varicella-zoster virus. Herpes zoster can cause several problems with the eye and surrounding skin that may have long term effects.  It is a kind of herpes, which spreads half way around the body like a girdle and is usually results in violent neuralgic pain. Herpes zoster is characterized by painful skin lesions that occurs mainly on the trunk of the body but which can also develop on the face and in the mouth. Shingles are caused by the same virus that causes chickenpox. Zoster is generally affects the trunk and buttocks, but it can also appear on the face, arms, legs, upper abdomen and lower chest if nerves in these areas are involved. It can also appear along the other nerves including that leading to the eye and can cause serious ocular complications which lead to blindness. People with herpes zoster are considered contagious to persons who have never had chickenpox. People who have never had chickenpox can catch chickenpox if they have close contact with a person who has herpes zoster or shingles. However, you can not catch herpes zoster or shingles itself from someone else.

Herpes simplex virus may produce nearly identical lesions, but unlike herpes zoster, HSV tends to recur and is not dermatomal. Herpes zoster can be contagious through direct contact in an individual who has not had chickenpox, and therefore has no immunity. Herpes zoster causes a wide range of problems affecting the skin and the eye. They range in severity depending on the extent of the outbreak. Some problems listed occur indirectly from the inflammation caused by the disease. A person with shingles can spread the disease when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or with post-herpetic neuralgia. Herpes zoster is treated with anti-viral, pain and anti-inflammatory medications. Eye drops and ointments may be prescribed to treat ocular problems. In some cases, secondary conditions caused by herpes zoster may require surgery.

Causes of Herpes zoster

Herpes zoster occurs as a result of the virus re-emerging after many years. The cause of the re-activation is usually unknown, but seems to be linked to aging, stress, or an impaired immune system. Outbreaks occur for many different reasons, most of which are thought to be a result of events which depress the immune system, such as aging, severe emotional stress, severe illness or long-term use of corticosteroids. People with suppressed immune systems due to organ transplant or treatment for cancer are also at risk.

Common causes and risk factors of Herpes zoster:

  • Re-emerging of the virus after many years.
  • Bacterial infection.
  • severe emotional stress.
  • Advanced age.
  • Long-term use of corticosteroids.

Signs and Symptoms of Herpes zoster

The earliest symptoms of shingles include headache, sensitivity to light, flu-like symptoms without fever, as well as itching, tingling, and extreme pain where the rash is developing. This phase, called the prodromal phase, usually presents with pain as the first symptom, generally lasting one to two days. The initial phase is followed by development of the characteristic skin rashes of herpes zoster. The skin lesions begin as a rash, similar to hives, that follows a distribution near dermatones, commonly occurring in a strip or belt-like pattern. The rash evolves into vesicles or small blisters filled with serous fluid. A person with shingles can spread the disease when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer contagious.

Sign and symptoms may include the following :

  • Fever and meningitis.
  • Pain and burning sensation.
  • Small blisters.
  • Vision abnormalities and taste abnormalities.
  • Headache.
  • General feeling of malaise.

Treatment for Herpes zoster

Herpes zoster is treated with anti-viral, pain and anti-inflammatory medications. For the greatest effect, treatment with acyclovir-like medications should start within 24 hours of the appearance of pain or burning sensation, and preferably before the appearance of the characteristic blisters. Immunocompromised patients may respond best to intravenous acyclovir. In patients who are at high risk for recurrences, an oral dose of acyclovir, taken twice daily, is usually effective. Eye drops and ointments may be prescribed to treat ocular problems.  In some cases, secondary conditions caused by herpes zoster may require surgery.

Treatment may include:

  • Herpes zoster can be treated with antivirals, anti-inflammatory medications and aspirin and other analgesics are used to relieve pain.these also reduce the duration of the disease.
  • Several creams, gels and sprays are being studied. These provide temporary relief from pain.
  • Eye drops and ointments may be prescribed by the doctors to treat ocular problems.
  • Secondary condition secondary conditions caused by herpes zoste may require surgery.