Shingles-Herpes Zoster

Shingles is medically known as Herpes Zoster. It is not a very common disorder but anyone who gets it, is unlikely to forget it. It is characterized by painful blisters and a rash. Shingles usually occurs once in a life time, but this is not a rigid rule- some unfortunate individuals can have multiple outbreaks over a life time.

Shingles is caused by a virus which is very similar to herpes simplex, but in this case the virus is called varicella zoster. Varicella is also the cause of chicken pox. Once the chicken pox has subsided, the virus does not die. It has a great affinity for the nerve and hides there until one day; it decides to break out as a painful rash.

The painful rash is classic. Since the virus resides in a nerve, when reactivated, it always causes the painful rash in the distribution of the nerve pathway. The rash is almost always linear in its distribution and this is what makes it very recognizable.

Everyone who gets shingles gets a premonition that something is not right. The rash and the pain come on all of a sudden and may be an overnight occurrence. The pain is almost always burning in nature and intense. Many individuals have presented to the emergency room thinking they were having a heart attack or something very sinister.

For unknown reason, the rash almost always occurs on the left side of the chest. The rash may start off in the back and run along the front across to the nipple line. Sleeping is impossible on that side because of the pain.

The pain of shingles can be excruciating, and the cause is not always recognized. But once the typical linear rash and blisters appear on one side of your body, the diagnosis of shingles is made.

In some cases, there is only a painful rash and the blisters appear a few days later.

Sometimes the rash can occur on the neck, face or scalp.

In most cases, the pain and the rash are the initial presentation, followed by the blisters 2-4 days later. Sometimes the blisters may be delayed for up to 2 weeks. In rare cases, the blisters may rupture and ooze fluid.

The rash is always painful to touch.

Besides the chest, shingles also occur just around the eye. Only one eye is affected. This occurs in the elderly and can lead to visual loss if not promptly treated.

In some individuals who are immunocompromised or ill, the shingles can spread throughout the body. In these cases, the condition can be life threatening and urgent IV therapy is required.

Shingles is not a life-threatening disorder but can cause intense pain. Some unfortunate individuals develop a condition known as post herpetic neuralgia. This condition causes the skin to remain painful and sensitive to touch for months or even years after the rash clears up.

Vaccines are available to decrease the risk of shingles. When give on time, the vaccine can help shorten a shingles infection and decrease the chance of complications.

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