| Shingles | |
|---|---|
| Other names | Zoster, herpes zoster, zona |
 | |
| Herpes zoster blisters on the neck and shoulder | |
| Specialty | Dermatology |
| Symptoms | Painful rash occurring in a stripe[1] |
| Complications | Postherpetic neuralgia[1] |
| Duration | 2–4 weeks[2] |
| Causes | Varicella zoster virus (VZV)[1] |
| Risk factors | Old age, poor immune function, having had chickenpox before 18 months of age[1] |
| Diagnostic method | Based on symptoms[3] |
| Differential diagnosis | Herpes simplex, angina, insect bites[4] |
| Prevention | Shingles vaccine[1] |
| Medication | Aciclovir (if given early), pain medication[3] |
| Frequency | 33% (at some point)[1] |
| Deaths | 6,400 (with chickenpox)[5] |
Shingles, also known as zoster or herpes zoster, is a viral disease characterized by a painful skin rash with blisters in a localized area.[2][6] Typically the rash occurs in a single, wide stripe either on the left or right side of the body or face.[1] Two to four days before the rash occurs there may be tingling or local pain in the area.[1][7] Otherwise there are typically few symptoms though some may have fever or headache, or feel tired.[1][8] The rash usually heals within two to four weeks;[2] however, some people develop ongoing nerve pain which can last for months or years, a condition called postherpetic neuralgia (PHN).[1] In those with poor immune function the rash may occur widely.[1] If the rash involves the eye, vision loss may occur.[2][9]
Shingles is due to a reactivation of varicella zoster virus (VZV) in a person's body.[1] The disease chickenpox is caused by the initial infection with VZV.[1] Once chickenpox has resolved, the virus may remain inactive in nerve cells.[1] When it reactivates, it travels from the nerve body to the endings in the skin, producing blisters.[7] Risk factors for reactivation include old age, poor immune function, and having had chickenpox before 18 months of age.[1] How the virus remains in the body or subsequently re-activates is not well understood.[1] Exposure to the virus in the blisters can cause chickenpox in someone who has not had it, but will not trigger shingles.[10] Diagnosis is typically based on a person's signs and symptoms.[3] Varicella zoster virus is not the same as herpes simplex virus; however, they belong to the same family of viruses.[11]
The shingles vaccine reduces the risk of shingles by 50% to 90%, depending on the vaccine used.[1][12] It also decreases rates of postherpetic neuralgia, and if shingles occurs, its severity.[1] 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.[3] Evidence does not show a significant effect of antivirals or steroids on rates of postherpetic neuralgia.[13][14] Paracetamol, NSAIDs, or opioids may be used to help with the acute pain.[3]
It is estimated that about a third of people develop shingles at some point in their life.[1] While more common among older people, children may also get the disease.[11] The number of new cases per year ranges from 1.2 to 3.4 per 1,000 person-years among healthy individuals to 3.9 to 11.8 per 1,000 person-years among those older than 65 years of age.[8] About half of those living to age 85 will have at least one attack, and less than 5% will have more than one attack.[1][15] The disease has been recognized since ancient times.[1]
References edit
- ^ a b c d e f g h i j k l m n o p q r s t u Hamborsky J, Kroger A, Wolfe S, eds. (2015). "Chapter 22: Varicella". Epidemiology and Prevention of Vaccine-Preventable Diseases (13th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC). ISBN 978-0990449119. Archived from the original on 2016-12-30. Retrieved 2020-01-09.
This article incorporates text from this source, which is in the public domain.
- ^ a b c d "Shingles (Herpes Zoster) Signs & Symptoms". Centers for Disease Control and Prevention (CDC). May 1, 2014. Archived from the original on 26 May 2015. Retrieved 26 May 2015. This article incorporates text from this source, which is in the public domain.
- ^ a b c d e Cohen, JI (18 July 2013). "Clinical practice: Herpes zoster". The New England Journal of Medicine. 369 (3): 255–63. doi:10.1056/NEJMcp1302674. PMC 4789101. PMID 23863052.
- ^ Kahan, Scott (2003). In a Page Medicine. Lippincott Williams & Wilkins. p. 215. ISBN 9781405103251. Archived from the original on 2019-12-17. Retrieved 2017-09-11.
- ^ GBD 2015 Mortality and Causes of Death Collaborators (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
- ^ Rajendran, Arya; Sivapathasundharam, B (2014). Shafer's textbook of oral pathology (Seventh ed.). p. 351. ISBN 9788131238004. Archived from the original on 2019-12-17. Retrieved 2017-09-11.
- ^ a b Gagliardi, Anna Mz; Andriolo, Brenda Ng; Torloni, Maria Regina; Soares, Bernardo Go; de Oliveira Gomes, Juliana; Andriolo, Regis B.; Canteiro Cruz, Eduardo (7 November 2019). "Vaccines for preventing herpes zoster in older adults". The Cochrane Database of Systematic Reviews. 2019 (11). doi:10.1002/14651858.CD008858.pub4. ISSN 1469-493X. PMC 6836378. PMID 31696946.
- ^ a b Dworkin RH, Johnson RW, Breuer J, et al. (2007). "Recommendations for the management of herpes zoster". Clin. Infect. Dis. 44 Suppl 1: S1–26. doi:10.1086/510206. PMID 17143845.
- ^ Johnson RW, Alvarez-Pasquin MJ, Bijl M, et al. (2015). "Herpes zoster epidemiology, management, and disease and economic burden in Europe: A multidisciplinary perspective". Therapeutic Advances in Vaccines. 3 (4): 109–20. doi:10.1177/2051013615599151. PMC 4591524. PMID 26478818.
- ^ "Shingles (Herpes Zoster) Transmission". Centers for Disease Control and Prevention (CDC). September 17, 2014. Archived from the original on 6 May 2015. Retrieved 26 May 2015. This article incorporates text from this source, which is in the public domain.
- ^ a b "Overview". Centers for Disease Control and Prevention (CDC). September 17, 2014. Archived from the original on 16 May 2015. Retrieved 26 May 2015. This article incorporates text from this source, which is in the public domain.
- ^ Cunningham, AL (2016). "The herpes zoster subunit vaccine". Expert Opinion on Biological Therapy. 16 (2): 265–71. doi:10.1517/14712598.2016.1134481. PMID 26865048.
- ^ Chen N, Li Q, Yang J, et al. (6 February 2014). "Antiviral treatment for preventing postherpetic neuralgia". Cochrane Database of Systematic Reviews. 2 (2): CD006866. doi:10.1002/14651858.CD006866.pub3. PMID 24500927.
- ^ Han Y, Zhang J, Chen N, et al. (28 March 2013). Han Y (ed.). "Corticosteroids for preventing postherpetic neuralgia". Cochrane Database of Systematic Reviews. 3 (3): CD005582. doi:10.1002/14651858.CD005582.pub4. PMID 23543541.
- ^ Honorio T. Benzon (2011). Essentials of Pain Medicine (3rd ed.). London: Elsevier Health Sciences. p. 358. ISBN 9781437735932. Archived from the original on 2019-12-17. Retrieved 2017-09-11.
