Herpes Simplex Virus

Shingles Disease


Shingles, also called herpes zoster, is a disease caused by the varicella-zoster virus, which is the virus that causes chickenpox.

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Shingles Disease

General information

Shingles Disease occurs in people who have had chickenpox and represents a reactivation of the dormant varicella-zoster virus.

The Shingles disease generally affects the elderly, although it occasionally occurs in younger and/or immunodeficient individuals, especially under times of severe stress. The first sign is usually a tingling feeling, itchiness, or stabbing pain on the skin. After a few days, a rash appears as a band or patch of raised dots on the side of the trunk or face. The rash develops into small, fluid-filled blisters which begin to dry out and crust over within several days. When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain. Contact with a person with shingles may cause chickenpox (but not shingles) in someone who has never had chickenpox before. This rash is generally limited to one dermatome on the body, which explains its confined appearance.

The reawakened virus generally causes a vague burning sensation or tingling over an area of skin.

A painful rash usually occurs two to five days after the first symptoms appear. A cluster of small bumps (1) turns into blisters (2) that resemble chickenpox lesions. The blisters fill with pus, break open (3), crust over (4), and finally disappear. This process takes four to five weeks. A painful condition called post-herpetic neuralgia can sometimes occur. This condition is thought to be caused by damage to the nerves (5), and can last from weeks to years after the rash disappears.

Treatment

Treatment for shingles disease includes antiviral drugs, steroids, antidepressants, anticonvulsants, and topical agents. The severity and duration of an attack of Shingles Disease can be significantly reduced by immediate treatment with the antiviral drugs acyclovir, valacyclovir or famcyclovir. An antiepileptic gabapentin and a transdermal anaesthetic lidocaine are often used as the first-choice treatments in the postherpetic neuralgia.

Prognosis

Although shingles can be very painful and itchy, it is not generally dangerous to healthy individuals and it usually resolves without complications. The rash and pain usually subside within 3 to 5 weeks. Sometimes serious effects including partial facial paralysis (usually temporary), ear damage, or encephalitis may occur. Persons with shingles on the upper half of the face should seek medical attention immediately as the virus may cause serious damage to the eyes. Most people who have shingles have only one bout with the disease in their lifetime. However, individuals with impaired immune systems, i.e., people with AIDS or cancer, may suffer repeated episodes.

The long term complication is the post-herpetic neuralgia that may cause persistent pain that lasts for years.


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  :: Herpes treatment
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