Herpes zoster

Shingles
Synonyms	zoster, herpes zoster, zona
Herpes zoster blisters on the neck and shoulder
Classification and external resources
Specialty	Dermatology
ICD-10	B02
ICD-9-CM	053
DiseasesDB	29119
MedlinePlus	000858
eMedicine	med/1007 derm/180 emerg/823 oph/257 ped/996
Patient UK	Shingles
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Shingles, also known as herpes zoster, is a viral disease characterized by a painful skin rash with blisters in a localized area. Typically the rash occurs in a single stripe either on the left or right of the body or face. Two to four days before the rash occurs there may be tingling or local pain in the area. Otherwise there are typically few symptoms. The rash usually heals within two to four weeks; however, some people develop ongoing nerve pain which can last for months or years, a condition called postherpetic neuralgia. In those with poor immune function the rash may occur widely. If the rash involves the eye, vision loss may occur.

Shingles is due to a reactivation of varicella zoster virus (VZV) within a person's body. Chickenpox is due to an initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. When it reactivates it travels from the nerve body to the endings in the skin producing blisters. Risk factors for reactivation include old age, poor immune function, and having had chickenpox before 18 months of age. How the virus remains in the body or subsequently re-activates, is not well understood. Exposure to the virus in the blisters can cause chickenpox in someone who has not had it before but will not trigger shingles. Diagnosis is typically based on a person's signs and symptoms. Varicella zoster virus is not the same as herpes simplex virus; however, they belong to the same family of viruses.

The shingles vaccine decreases the chance of shingles by about half in those between the ages of 50 and 80. It also decreases rates of postherpetic neuralgia, and if an outbreak occurs, its severity. After 80 the vaccine is still effective, just less so. It contains the same material as the varicella vaccine, just at a higher dose. If shingles develops, antiviral medications such as aciclovir can reduce the severity and duration of disease if started within 72 hours of the appearance of the rash. Evidence does not show a significant effect of antivirals or steroids on rates of postherpetic neuralgia.Paracetamol, NSAIDs, or opioids may be used to help with the acute pain.

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Wikipedia