Shingles

Description

Herpes zoster, also called shingles, and referred to as "zosteer", gets its name from both the Latin and French words for belt or girdle and refers to belt-like skin eruptions that may occur on the trunk of the body. The virus that causes chickenpox, the varicella zoster virus (VSV), can become dormant in nerve cells after an episode of chickenpox and later re-emerge as shingles. Any individual who has had chickenpox can develop shingles. People of all ages, even children, can be affected, but the incidence increases with age. There are many other conditions which can predispose to developing shingles. These include: newborn infants, bone marrow and other transplant recipients, and individuals with immune systems weakened by diseases like HIV or cancer, or drugs, such as those used in chemotherapy.

Shingles erupts along the course of the affected nerve, producing lesions anywhere on the body and may cause severe nerve pain. The most common areas to be affected are the face and trunk, which correspond to the areas where the chickenpox rash is most concentrated. The disease is caused by a reactivation of the chickenpox virus that has been dormant in certain nerves following an episode of chickenpox. Exactly how or why this reactivation occurs is not clear; however, it is believed that the reactivation is triggered when the immune system becomes weakened as in the examples described above. Early signs of shingles are often vague and can easily be mistaken for other illnesses. The condition may begin with fever and malaise (a vague feeling of weakness or discomfort). Within two to four days, severe pain, itching, and numbness/tingling (paresthesia) or extreme sensitivity to touch (hyperesthesia) can develop, usually on the trunk and occasionally on the arms and legs. Pain may be continuous or intermittent, usually lasting from one to four weeks. It may occur at the time of the eruption, but can precede the eruption by days, occasionally making the diagnosis difficult. Signs and symptoms may include the following:

• itching, tingling, or severe burning pain
• red patches that develop into blisters
• grouped, dense, deep, small blisters that ooze and crust
• swollen lymph nodes

Immunocompromised patients usually have a more severe course that is frequently prolonged for weeks to months. They develop shingles frequently and the infection can spread to the skin, lungs, liver, gastrointestinal tract, brain, or other vital organs.

Potentially serious complications can result from herpes zoster. Many individuals continue to experience persistent pain long after the blisters heal. This pain, called post-herpatic neuralgia, can be severe and debilitating. Post-herpetic neuralgia can persist for months or years after the lesions have disappeared.

Other complications include a secondary bacterial infection, and rarely, potentially fatal inflammation of the brain (encephalitis) and the spread of an infection throughout the body. These rare, but extremely serious, complications are more likely to occur in those individuals who have weakened immune systems (immunocompromised).

Content
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Author Info: David Greenberg M.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Cancer, 2002

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.