Herpes zoster (commonly called "shingles") results from reactivation of the varicella-zoster virus (VZV) acquired during a primary varicella infection (chickenpox). Primary VZV infection occurs when a susceptible individual (usually a child) is exposed to airborne virus via a respiratory route. Over 90% of adults in the United States have evidence of prior VZV infection on blood testing.
While zoster can erupt on almost any part of the body, the most common areas are the face and the torso. The characteristic rash of herpes zoster is often preceded by a prodrome of burning pain, itching or sensitivity of the affected area.
The skin lesions begin as a red, raised rash that follows a dermatomal distribution. The rash evolves into small fluid-filled blisters (vesicles) on a reddened base. The vesicles are generally painful, and their development is often associated with the occurrence of flu-like symptoms and anxiety. The vesicles eventually become cloudy and may bleed. Within 7-10 days, the vesicles crust over. As these crusts fall off, scarring and changes in skin color may remain.
While medications do not cure zoster infections, they have been found to help shorten the duration and discomfort of the outbreak. Perhaps more importantly, antiviral medications have been found to help reduce or prevent the occurrence of postherpetic neuralgia pain.
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Zoster paresis of the shoulder. Case report and review of the literature. Clinical Orthopaedics & Related Research. 2000
The role of sympathetic nerve blocks in herpes zoster and postherpetic neuralgia. Pain. 2000
Acute and chronic herpes zoster. An ancient scourge yields to timely therapy. Postgraduate Medicine. 2000
Valaciclovir: a review of its use in the management of herpes zoster. Drugs. 2000
Varicella-Zoster virus: pathogenesis, immunity, and clinical management in hematopoietic cell transplant recipients. Biology of Blood & Marrow Transplantation. 2000
Prospects for the prevention of postherpetic neuralgia in herpes zoster patients. Clinical Journal of Pain. 2000
Treatment of postherpetic neuralgia: an update. Drugs. 2000
Management of herpes zoster (shingles) and postherpetic neuralgia. American Family Physician. 2000
Does treatment of acute herpes zoster prevent or shorten postherpetic neuralgia?. Journal of Family Practice. 2000
Neurologic complications of the reactivation of varicella-zoster virus. New England Journal of Medicine. 2000
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